Healthcare Provider Details

I. General information

NPI: 1619117140
Provider Name (Legal Business Name): STEPHANIE L DONOHUE NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/24/2009
Last Update Date: 06/02/2026
Certification Date: 06/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1971 E 35TH ST
BROOKLYN NY
11234-4820
US

IV. Provider business mailing address

1971 E 35TH ST
BROOKLYN NY
11234-4820
US

V. Phone/Fax

Practice location:
  • Phone: 917-288-0250
  • Fax: 646-453-4382
Mailing address:
  • Phone: 917-288-0250
  • Fax: 646-453-4382

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number335032
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: