Healthcare Provider Details

I. General information

NPI: 1407855380
Provider Name (Legal Business Name): DONNA ANN HODGENS N.P.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/21/2005
Last Update Date: 12/10/2024
Certification Date: 12/10/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2 CROSFIELD AVE SUITE 318
WEST NYACK NY
10994-2226
US

IV. Provider business mailing address

331 NEWMAN SPRINGS RD STE 220
RED BANK NJ
07701-5792
US

V. Phone/Fax

Practice location:
  • Phone: 845-353-5600
  • Fax: 845-353-3474
Mailing address:
  • Phone: 732-807-0877
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number26NR08692200
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: