Provider Demographics
NPI:1174625263
Name:DONKINA, LUIZA (MD)
Entity type:Individual
Prefix:DR
First Name:LUIZA
Middle Name:
Last Name:DONKINA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:40-06 MORLOT AVE
Mailing Address - Street 2:
Mailing Address - City:FAIR LAWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07410-4939
Mailing Address - Country:US
Mailing Address - Phone:201-797-5836
Mailing Address - Fax:201-797-5836
Practice Address - Street 1:40-06 MORLOT AVE
Practice Address - Street 2:
Practice Address - City:FAIR LAWN
Practice Address - State:NJ
Practice Address - Zip Code:07410-4939
Practice Address - Country:US
Practice Address - Phone:201-797-5836
Practice Address - Fax:201-797-5836
Is Sole Proprietor?:No
Enumeration Date:2006-09-01
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA06651200207R00000X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Not Answered208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ7555709Medicaid
NJ7555709Medicaid
BD5727207OtherDEA
G66503Medicare UPIN