Provider Demographics
NPI:1265764633
Name:CARRAZZONE, DONNA
Entity type:Individual
Prefix:DR
First Name:DONNA
Middle Name:
Last Name:CARRAZZONE
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 1:71 W AIRMOUNT RD
Mailing Address - Street 2:
Mailing Address - City:MAHWAH
Mailing Address - State:NJ
Mailing Address - Zip Code:07430-1717
Mailing Address - Country:US
Mailing Address - Phone:210-252-2040
Mailing Address - Fax:
Practice Address - Street 1:71 W AIRMOUNT RD
Practice Address - Street 2:
Practice Address - City:MAHWAH
Practice Address - State:NJ
Practice Address - Zip Code:07430-1717
Practice Address - Country:US
Practice Address - Phone:210-252-2040
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-09
Last Update Date:2010-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NN08448200363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily