1720219348 NPI number — DONNA M MACNEIL RN, DIPL ABT, ABT CP

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1720219348 NPI number — DONNA M MACNEIL RN, DIPL ABT, ABT CP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MACNEIL
Provider First Name:
DONNA
Provider Middle Name:
M
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
RN, DIPL ABT, ABT CP
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:
1720219348
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/30/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
968 PLYMOUTH ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
EAST BRIDGEWATER
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
02333-2169
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
774-273-3000
Provider Business Mailing Address Fax Number:
508-378-8313

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
968 PLYMOUTH ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
EAST BRIDGEWATER
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
02333-2169
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
774-273-3000
Provider Business Practice Location Address Fax Number:
508-378-8313
Provider Enumeration Date:
07/30/2009

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: 146L00000X , with the licence number:  821075 , registered in the state of MA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 163WC0200X , with the licence number: 142206 , registered in the state of MA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 173C00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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