Provider Demographics
NPI:1174138432
Name:CHAMBERLAIN, DONYA
Entity type:Individual
Prefix:
First Name:DONYA
Middle Name:
Last Name:CHAMBERLAIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:313 HOLLAND ST
Mailing Address - Street 2:
Mailing Address - City:CRUM LYNNE
Mailing Address - State:PA
Mailing Address - Zip Code:19022-1107
Mailing Address - Country:US
Mailing Address - Phone:215-873-5535
Mailing Address - Fax:
Practice Address - Street 1:25 WESTERLY DR
Practice Address - Street 2:
Practice Address - City:SICKLERVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08081-3031
Practice Address - Country:US
Practice Address - Phone:215-873-5535
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-14
Last Update Date:2020-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home