1336898303 NPI number — DONNA HEFFERNAN MD PLLC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1336898303 NPI number — DONNA HEFFERNAN MD PLLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
DONNA HEFFERNAN MD PLLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1336898303
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/07/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 3203
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SCHENECTADY
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
12303-0203
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
518-346-3100
Provider Business Mailing Address Fax Number:
877-583-1284

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
63 EAST RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
TROY
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
12180-6860
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
518-346-3100
Provider Business Practice Location Address Fax Number:
877-583-1284
Provider Enumeration Date:
03/18/2022

Additional Information

Authorized Official

Authorized Official Last Name:
STEVENSON
Authorized Official First Name:
PATRICIA
Authorized Official Middle Name:
A
Authorized Official Title or Position:
PRACTICE MANAGER
Authorized Official Telephone Number:
518-346-3100

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 1336898303 . This is a "HIGHMARK" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 1336898303 . This is a "GEHA" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 1336898303 . This is a "GHI" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 1336898303 . This is a "WELLCARE AMERICAN PROGRESSIVE" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 1336898303 . This is a "CDPHP" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 02425056 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1336898303 . This is a "MVP HEALTH PLAN" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 1336898303 . This is a "AETNA" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 01666792112180000 . This is a "TRICARE" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 1336898303 . This is a "EMBLEM HEALTH" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 1336898303 . This is a "HUMANA" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 1336898303 . This is a "UNITED HEALTHCARE" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".




Copyright © 2007-2026 www.npivalidator.com