Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Glenn Donatelli

Individual provider Adult Health Nurse Practitioner · NPI 1588372296

Glenn Donatelli is a Nurse Practitioner in Sayville, New York. Qualified in 2022, 4 years ago. Practices with Kenneth Mark MD PC, a 2-clinician group and accepts Medicare assignment. Licensed in New York.

Years since qualifying
4
Licensed in
NY
In the registry since
2022

Practice location Address checks out

43 Broadway Ave
Sayville, NY 11782-1601
Phone: (631) 398-8568
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Adult Health Nurse Practitioner (primary) Taxonomy 363LA2200X · Licence 310883 (NY)

Record details

NPI number1588372296
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedNovember 10, 2022
Last updated in NPPESDecember 15, 2022
Certification dateDecember 15, 2022
Mailing address43 Broadway Ave, Sayville, NY 11782-1601

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2022 (4 years in practice)
Group practice Kenneth Mark Md Pc — 2 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

Other providers in Sayville