Provider Demographics
NPI:1689688376
Name:INGRAM, DONNA A (MD)
Entity Type:Individual
Prefix:
First Name:DONNA
Middle Name:A
Last Name:INGRAM
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:177 EAST 87TH STREET
Mailing Address - Street 2:SUITE 507
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10128
Mailing Address - Country:US
Mailing Address - Phone:212-828-3200
Mailing Address - Fax:212-828-3240
Practice Address - Street 1:177 EAST 87TH STREET
Practice Address - Street 2:SUITE 507
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10128
Practice Address - Country:US
Practice Address - Phone:212-828-3200
Practice Address - Fax:212-828-3240
Is Sole Proprietor?:No
Enumeration Date:2006-07-28
Last Update Date:2012-09-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY189818207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
6744523-007OtherCIGNA
4675205OtherAETNA PPR
P2480126OtherOXFORD
16978POtherHIP
1390967OtherUNITED HEALTHCARE
2355798OtherAETNA HMO
33J332OtherEMPIRE BC/BS
3C0361OtherHEALTHNET
33J331Medicare ID - Type Unspecified
6744523-007OtherCIGNA