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General NPI Number Information
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NPI Number | 1003842287
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Entity Type | Individual
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Provider Name | DONNA MARIE HEFFERNAN M.D.
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Gender | Female
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Dates
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Enumeration Date | 06/23/2006
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Last Update Date | 02/05/2025
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Provider Practice Location Address
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Address Line | 63 EAST RD
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City | TROY
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State | NY
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Zip | 12180-6860
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Country | US
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Telephone | 518-346-3100
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Fax | 877-583-1284
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Provider Business Mailing Address
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Address Line | PO BOX 3203
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City | SCHENECTADY
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State | NY
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Zip | 12303-0203
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Country | US
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Telephone | 518-346-3100
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Fax | 518-688-1342
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 2272751
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 227275
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License Number State | NY
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