Provider Demographics
NPI:1407807803
Name:DONSKY, DMITRY GREGORY (MD)
Entity Type:Individual
Prefix:DR
First Name:DMITRY
Middle Name:GREGORY
Last Name:DONSKY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:51 BUCKLEY RD
Mailing Address - Street 2:
Mailing Address - City:MARLBORO
Mailing Address - State:NJ
Mailing Address - Zip Code:07746-2108
Mailing Address - Country:US
Mailing Address - Phone:732-462-7849
Mailing Address - Fax:732-462-5989
Practice Address - Street 1:453 77TH ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11209-3205
Practice Address - Country:US
Practice Address - Phone:718-238-5729
Practice Address - Fax:718-238-2047
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-12
Last Update Date:2008-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY220763207P00000X, 207R00000X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02155755Medicaid
NY02155755Medicaid
NY18S311Medicare PIN