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General NPI Number Information
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NPI Number | 1568507788
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Entity Type | Individual
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Provider Name | ANNA DONNELLY MD
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Gender | Female
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Dates
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Enumeration Date | 02/21/2007
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Last Update Date | 02/17/2009
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Provider Practice Location Address
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Address Line | 590 AVENUE OF THE AMERICAS MEDICAL OFFICE 1ST FLOOR
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City | NEW YORK
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State | NY
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Zip | 10011-2019
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Country | US
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Telephone | 212-886-4097
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Fax | 212-206-4161
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Provider Business Mailing Address
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Address Line | 7906 35TH AVE APT 4N
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City | JACKSON HEIGHTS
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State | NY
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Zip | 11372-2720
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Country | US
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Telephone | 718-205-5012
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Fax | 718-205-5012
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 240794
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License Number State | NY
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