Individual ProviderDonna Marie MandartLicensed Practical NurseNursing Service ProvidersPractice Address42 Gina Ct, East Patchogue, NY 11772-4265(631) 758-1936PECOS EnrollmentBased on the most recent information from CMS, provider Donna Marie Mandart does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 2 days ago.Profile DetailsProvider ID1255526463Provider TypeIndividualFull NameMandart, Donna MarieTitleMrs.CredentialLPNGenderFemaleSole ProprietorYesEnumeration Date9/11/2007Last Updated9/11/2007Contact InformationPractice LocationPractice Address42 Gina Ct, East Patchogue, NY 11772-4265Phone(631) 758-1936FaxUnlisted FaxMailing LocationMailing Address42 Gina Ct, East Patchogue, NY 11772-4265Phone(631) 758-1936FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode164W00000XPrimaryDescriptionLicensed Practical NurseNursing Service ProvidersLicense203296-1New YorkProvider IdentifiersIDDescriptionIssuerID02860259DescriptionMedicaidIssuerUnlistedNew York