Provider Demographics
NPI:1114092335
Name:DONN, GULBAHAR P (MD)
Entity Type:Individual
Prefix:
First Name:GULBAHAR
Middle Name:P
Last Name:DONN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3519 223RD ST
Mailing Address - Street 2:
Mailing Address - City:BAYSIDE
Mailing Address - State:NY
Mailing Address - Zip Code:11361-2236
Mailing Address - Country:US
Mailing Address - Phone:718-423-1671
Mailing Address - Fax:718-446-0527
Practice Address - Street 1:8306 QUEENS BLVD
Practice Address - Street 2:
Practice Address - City:ELMHURST
Practice Address - State:NY
Practice Address - Zip Code:11373-4245
Practice Address - Country:US
Practice Address - Phone:718-424-8100
Practice Address - Fax:718-446-0527
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-22
Last Update Date:2013-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY212628207V00000X, 207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02099778Medicaid
246E21Medicare PIN
NY02099778Medicaid