Healthcare Provider Details

I. General information

NPI: 1720503352
Provider Name (Legal Business Name): DONALD MUNRO FOX, MD PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/04/2017
Last Update Date: 03/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

30 CENTRAL PARK S RM 10A
NEW YORK NY
10019-1628
US

IV. Provider business mailing address

120 CABRINI BLVD APT 72
NEW YORK NY
10033-3430
US

V. Phone/Fax

Practice location:
  • Phone: 212-772-1500
  • Fax: 212-751-0118
Mailing address:
  • Phone: 212-543-3180
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QM2500X
TaxonomyMedical Specialty Clinic/Center
License Number175-459
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code207WX0200X
TaxonomyOphthalmic Plastic and Reconstructive Surgery Physician
License Number175-459
License Number StateNY

VIII. Authorized Official

Name: DR. DONALD FOX
Title or Position: PRESIDENT/CEO
Credential: MD
Phone: 212-772-1500