Provider Demographics
NPI:1447371307
Name:VALLONE, DONNA CEIL (NP)
Entity type:Individual
Prefix:MS
First Name:DONNA
Middle Name:CEIL
Last Name:VALLONE
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 CAROLINE AVE.
Mailing Address - Street 2:
Mailing Address - City:SETAUKET
Mailing Address - State:NY
Mailing Address - Zip Code:11733-1116
Mailing Address - Country:US
Mailing Address - Phone:631-751-9590
Mailing Address - Fax:
Practice Address - Street 1:365 COUNTY ROAD 39A
Practice Address - Street 2:SUITE14
Practice Address - City:SOUTHAMPTON
Practice Address - State:NY
Practice Address - Zip Code:11968-5284
Practice Address - Country:US
Practice Address - Phone:631-726-8033
Practice Address - Fax:631-726-8031
Is Sole Proprietor?:No
Enumeration Date:2007-04-02
Last Update Date:2014-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF380836-1363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYS46657Medicare UPIN
NY91V681Medicare ID - Type Unspecified