Provider Demographics
NPI:1366467029
Name:GILMORE, DONNA M (MD)
Entity Type:Individual
Prefix:DR
First Name:DONNA
Middle Name:M
Last Name:GILMORE
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Gender:F
Credentials:MD
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Mailing Address - Street 1:301 E 22ND ST
Mailing Address - Street 2:APARTMENT 9 J
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10010-4816
Mailing Address - Country:US
Mailing Address - Phone:212-254-1785
Mailing Address - Fax:212-254-1785
Practice Address - Street 1:1090 AMSTERDAM AVE
Practice Address - Street 2:SUITE 16C
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10025-1737
Practice Address - Country:US
Practice Address - Phone:212-523-2965
Practice Address - Fax:212-636-1303
Is Sole Proprietor?:No
Enumeration Date:2006-07-13
Last Update Date:2007-07-09
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Provider Licenses
StateLicense IDTaxonomies
NY185103207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01740647Medicaid
NY01740647Medicaid
NYG05022Medicare UPIN