Provider Demographics
NPI:1164302170
Name:DONCKERS, GRETTA
Entity type:Individual
Prefix:
First Name:GRETTA
Middle Name:
Last Name:DONCKERS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:GREY
Other - Middle Name:
Other - Last Name:DONCKERS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:867 BOYLSTON ST FL 5
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02116-2774
Mailing Address - Country:US
Mailing Address - Phone:508-233-8901
Mailing Address - Fax:888-913-7256
Practice Address - Street 1:867 BOYLSTON ST FL 5
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02116-2774
Practice Address - Country:US
Practice Address - Phone:508-233-8901
Practice Address - Fax:888-913-7256
Is Sole Proprietor?:No
Enumeration Date:2025-09-03
Last Update Date:2025-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program