Provider Demographics
NPI:1881706943
Name:HENRY, DONNA MARIE (MD)
Entity type:Individual
Prefix:
First Name:DONNA
Middle Name:MARIE
Last Name:HENRY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:131 E AMES CT
Mailing Address - Street 2:
Mailing Address - City:PLAINVIEW
Mailing Address - State:NY
Mailing Address - Zip Code:11803-2317
Mailing Address - Country:US
Mailing Address - Phone:914-738-9243
Mailing Address - Fax:
Practice Address - Street 1:2426 EASTCHESTER RD
Practice Address - Street 2:SUITE 208
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10469-5947
Practice Address - Country:US
Practice Address - Phone:718-708-5650
Practice Address - Fax:718-708-5619
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2016-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY175081207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology