Healthcare Provider Details

I. General information

NPI: 1720170533
Provider Name (Legal Business Name): DONALD DUANE STONER PA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/29/2006
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

60 JEFFERSON ST STE 3 HUDSON RIVER HEALTHCARE, INC.
MONTICELLO NY
12701-1131
US

IV. Provider business mailing address

1200 BROWN ST 4TH FLOOR - CREDENTIALING
PEEKSKILL NY
10566-3617
US

V. Phone/Fax

Practice location:
  • Phone: 845-794-2010
  • Fax: 845-794-4569
Mailing address:
  • Phone: 914-734-8858
  • Fax: 914-734-8745

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number003363
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: