Healthcare Provider Details

I. General information

NPI: 1073709614
Provider Name (Legal Business Name): PHILIP DON
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/18/2007
Last Update Date: 09/18/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2600 NETHERLAND AVE APT 815N
BRONX NY
10463-4896
US

IV. Provider business mailing address

242 NAPLES TER
BRONX NY
10463-5465
US

V. Phone/Fax

Practice location:
  • Phone: 718-432-8282
  • Fax: 718-432-8271
Mailing address:
  • Phone: 718-432-8282
  • Fax: 718-432-8271

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number172357
License Number StateNY

VIII. Authorized Official

Name: PHILIP C DON
Title or Position: SOLE PROPRIETER
Credential:
Phone: 718-432-8282