Healthcare Provider Details

I. General information

NPI: 1861423436
Provider Name (Legal Business Name): STEPHANIE LYNN DONAHUE N.P.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/05/2006
Last Update Date: 06/13/2024
Certification Date: 06/13/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

505 E 70TH ST 2ND FLOOR
NEW YORK NY
10021-4872
US

IV. Provider business mailing address

504 E 74TH ST STE 506 5TH FLOOR
NEW YORK NY
10021-3486
US

V. Phone/Fax

Practice location:
  • Phone: 212-746-1578
  • Fax: 212-702-9588
Mailing address:
  • Phone: 212-249-4061
  • Fax: 212-249-4659

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberF333805-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: