Provider Demographics
NPI:1295724805
Name:ANTHONY, DONNA THERESE (MD PHD)
Entity type:Individual
Prefix:
First Name:DONNA
Middle Name:THERESE
Last Name:ANTHONY
Suffix:
Gender:F
Credentials:MD PHD
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Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:300 CENTRAL PARK W
Mailing Address - Street 2:STE 1K
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10024-1513
Mailing Address - Country:US
Mailing Address - Phone:212-873-6850
Mailing Address - Fax:212-997-5770
Practice Address - Street 1:300 CENTRAL PARK W
Practice Address - Street 2:STE 1K
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10024-1513
Practice Address - Country:US
Practice Address - Phone:212-873-6850
Practice Address - Fax:212-997-5770
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-17
Last Update Date:2011-12-19
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY17562212084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
E94758Medicare UPIN
91F101Medicare PIN