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General NPI Number Information
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NPI Number | 1003108424
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Entity Type | Individual
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Provider Name | DONNA BRACKEN MD
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Gender | Female
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Dates
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Enumeration Date | 05/03/2011
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Last Update Date | 03/28/2025
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Provider Practice Location Address
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Address Line | 506 MALCOLM X BLVD
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City | NEW YORK
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State | NY
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Zip | 10037-1802
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Country | US
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Telephone | 212-939-1000
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Fax |
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Provider Business Mailing Address
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Address Line | 506 MALCOLM X BLVD
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City | NEW YORK
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State | NY
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Zip | 10037-1802
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Country | US
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Telephone | 212-939-1000
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207LP2900X
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Taxonomy Name | Pain Medicine (Anesthesiology) Physician
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License Number | 280342
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 207LP3000X
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Taxonomy Name | Pediatric Anesthesiology Physician
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License Number | 280342
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 280342
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License Number State | NY
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