Healthcare Provider Details

I. General information

NPI: 1003808999
Provider Name (Legal Business Name): DONALD STONE HIGGINS JR. M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/17/2005
Last Update Date: 05/26/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

113 HOLLAND AVE NEUROLOGY SERVICE (127)
ALBANY NY
12208-3410
US

IV. Provider business mailing address

113 HOLLAND AVE NEUROLOGY SERVICE (127)
ALBANY NY
12208-3410
US

V. Phone/Fax

Practice location:
  • Phone: 518-626-6391
  • Fax: 518-626-6369
Mailing address:
  • Phone: 518-626-6391
  • Fax: 518-626-6369

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number189152
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: