Provider Demographics
NPI:1407855380
Name:HODGENS, DONNA ANN (NP)
Entity Type:Individual
Prefix:
First Name:DONNA
Middle Name:ANN
Last Name:HODGENS
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1301 ROUTE 72 W
Mailing Address - Street 2:STE 240
Mailing Address - City:MANAHAWKIN
Mailing Address - State:NJ
Mailing Address - Zip Code:08050-2483
Mailing Address - Country:US
Mailing Address - Phone:845-353-5600
Mailing Address - Fax:845-353-3474
Practice Address - Street 1:2 CROSFIELD AVE
Practice Address - Street 2:SUITE 318
Practice Address - City:WEST NYACK
Practice Address - State:NY
Practice Address - Zip Code:10994-2226
Practice Address - Country:US
Practice Address - Phone:845-353-5600
Practice Address - Fax:845-353-3474
Is Sole Proprietor?:No
Enumeration Date:2005-07-21
Last Update Date:2018-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NR08692200363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02645045Medicaid
NY5354LES611Medicare PIN
NYQ11028Medicare UPIN