Provider Demographics
NPI:1124276480
Name:SCHWIER, DONNA LEE (RN)
Entity type:Individual
Prefix:MS
First Name:DONNA
Middle Name:LEE
Last Name:SCHWIER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 MONTAUK PL
Mailing Address - Street 2:
Mailing Address - City:OAKDALE
Mailing Address - State:NY
Mailing Address - Zip Code:11769-1118
Mailing Address - Country:US
Mailing Address - Phone:631-256-6939
Mailing Address - Fax:
Practice Address - Street 1:12 MONTAUK PL
Practice Address - Street 2:
Practice Address - City:OAKDALE
Practice Address - State:NY
Practice Address - Zip Code:11769-1118
Practice Address - Country:US
Practice Address - Phone:631-256-6939
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-28
Last Update Date:2009-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY456731-1163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02760878Medicaid