Provider Demographics
NPI:1356423875
Name:DONOVAN, DANIEL S JR (MD, MS)
Entity type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:S
Last Name:DONOVAN
Suffix:JR
Gender:M
Credentials:MD, MS
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Mailing Address - Street 1:1 GUSTAVE L LEVY PL
Mailing Address - Street 2:BOX 3000
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10029-6504
Mailing Address - Country:US
Mailing Address - Phone:212-987-3100
Mailing Address - Fax:212-731-5210
Practice Address - Street 1:5 E 98TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10029-6501
Practice Address - Country:US
Practice Address - Phone:212-241-3422
Practice Address - Fax:212-423-0508
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-20
Last Update Date:2019-02-21
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Provider Licenses
StateLicense IDTaxonomies
NY173575207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01432888Medicaid
NYF63871Medicare UPIN
NY0108631007OtherCIGNA
NYNP540OtherOXFORD
NM110115825OtherRAILROAD MEDICARE
NY461098OtherAETNA
NY81H021OtherBCBS
NY81H022Medicare PIN