Healthcare Provider Details

I. General information

NPI: 1659356426
Provider Name (Legal Business Name): JEFFREY FRANKLYN DONIS D.P.M
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/14/2005
Last Update Date: 10/22/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

180 E HARTSDALE AVE
HARTSDALE NY
10530-3544
US

IV. Provider business mailing address

PO BOX 28064
NEW YORK NY
10087-8064
US

V. Phone/Fax

Practice location:
  • Phone: 914-725-2010
  • Fax: 914-725-6488
Mailing address:
  • Phone: 914-593-7880
  • Fax: 914-593-7881

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number002361
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code213ES0131X
TaxonomyFoot Surgery Podiatrist
License Number002361
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: