1922265859 NPI number — DR. LAURA DONARUMMO MD

Table of content: DR. LAURA DONARUMMO MD (NPI 1922265859)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1922265859 NPI number — DR. LAURA DONARUMMO MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
DONARUMMO
Provider First Name:
LAURA
Provider Middle Name:
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1922265859
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/06/2017
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
245 OLD COUNTRY RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MELVILLE
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
11747-2726
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
631-465-6141
Provider Business Mailing Address Fax Number:
631-465-1967

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
STONY BROOK UNIVERSITY HOSPITAL
Provider Second Line Business Practice Location Address:
DEPT OF NEUROLOGY HSC12
Provider Business Practice Location Address City Name:
STONY BROOK
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11794-8121
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
631-444-7878
Provider Business Practice Location Address Fax Number:
631-444-1474
Provider Enumeration Date:
05/19/2008

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 390200000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 2084N0400X , with the licence number: 254647 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)