Healthcare Provider Details

I. General information

NPI: 1790872877
Provider Name (Legal Business Name): DONNA DIMICHELE MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/09/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

525 E 68TH ST # P-695
NEW YORK NY
10021-4870
US

IV. Provider business mailing address

525 E 68TH ST # P-695
NEW YORK NY
10021-4870
US

V. Phone/Fax

Practice location:
  • Phone: 212-746-3400
  • Fax: 212-746-3988
Mailing address:
  • Phone: 212-746-0373
  • Fax: 212-746-7481

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number199985
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code2080P0207X
TaxonomyPediatric Hematology & Oncology Physician
License Number199985
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: