MEDICARE: DONNA MARIE HENRY M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207VG0400X	Gynecology Physician	175081	NY

General Provider Information

NPI Number	:	1881706943
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DONNA MARIE HENRY M.D.

Provider Business Mailing Address
First Line	:	131 E AMES CT
Second Line	:
City	:	PLAINVIEW
State	:	NY
Zip	:	11803-2317
Country	:	US
Telephone Number	:	914-738-9243
Fax Number	:

Provider Business Practice Location Address
First Line	:	2426 EASTCHESTER RD
Second Line	:	SUITE 208
City	:	BRONX
State	:	NY
Zip	:	10469-5947
Country	:	US
Telephone Number	:	718-708-5650
Fax Number	:	718-708-5619

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/31/2006
Last Update Date	:	11/30/2016

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