Provider Demographics
NPI:1003832627
Name:DONIN, ROBERTA LYNNE (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERTA
Middle Name:LYNNE
Last Name:DONIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:45 S ROUTE 9W STE 41 #114
Mailing Address - Street 2:
Mailing Address - City:WEST HAVERSTRAW
Mailing Address - State:NY
Mailing Address - Zip Code:10993-1053
Mailing Address - Country:US
Mailing Address - Phone:914-639-2067
Mailing Address - Fax:315-612-9793
Practice Address - Street 1:3765 RIVERDALE AVE
Practice Address - Street 2:SUITE 5
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10463-1845
Practice Address - Country:US
Practice Address - Phone:718-601-2700
Practice Address - Fax:718-601-9890
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-15
Last Update Date:2024-04-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY151945207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY134177588OtherUNITED HEALTH CARE
NY54C60OtherEMPIRE BC/BS PPO
NYRR MEDICAREOtherRAILROAD MEDICARE
NY01014671Medicaid
NY3C1766OtherPHS/HEALTHNET
NY5861192OtherAETNA PPO
NY2554370OtherAETNA HMO
NY3C1766OtherHEALTH NET
NY134177588Other1199
NYWP666OtherOXFORD
NY27821POtherHIP
NY84399OtherNYLCARE
NYWAA851OtherMEDICARE
NY01014671Medicaid