Provider Demographics
NPI:1922871763
Name:PRESTOPINO, DONNA MARIE
Entity type:Individual
Prefix:
First Name:DONNA
Middle Name:MARIE
Last Name:PRESTOPINO
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 1:8030 JERICHO TPKE STE 125
Mailing Address - Street 2:
Mailing Address - City:WOODBURY
Mailing Address - State:NY
Mailing Address - Zip Code:11797-1204
Mailing Address - Country:US
Mailing Address - Phone:929-338-3525
Mailing Address - Fax:
Practice Address - Street 1:8030 JERICHO TPKE STE 125
Practice Address - Street 2:
Practice Address - City:WOODBURY
Practice Address - State:NY
Practice Address - Zip Code:11797-1204
Practice Address - Country:US
Practice Address - Phone:929-338-3525
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-02
Last Update Date:2023-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY510100163WC0200X, 163WH0200X, 163WP2201X, 163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No163WC0200XNursing Service ProvidersRegistered NurseCritical Care Medicine
No163WH0200XNursing Service ProvidersRegistered NurseHome Health
No163WP2201XNursing Service ProvidersRegistered NurseAmbulatory Care