Healthcare Provider Details

I. General information

NPI: 1700814837
Provider Name (Legal Business Name): DANA O. DOHENY MS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/29/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1425 MADISON AVE ROOM 14-75A
NEW YORK NY
10029-6514
US

IV. Provider business mailing address

15 BORZOTTA BLVD
WAYNE NJ
07470-2503
US

V. Phone/Fax

Practice location:
  • Phone: 212-659-6779
  • Fax: 212-659-6780
Mailing address:
  • Phone: 973-942-5723
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code170300000X
TaxonomyGenetic Counselor (M.S.)
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: