Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | 227275 | NY |
NPI | 1003842287 |
---|---|
Provider Name | Dr. Donna Marie Heffernan |
First Address | Schenectady, NY 12303-0203 |
Second Address | Schenectady, NY 12309-2234 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/06/2006 |
Last Update Date | 08/06/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000404017001 | BSNENY (01) | NY |
02425056 | (05) | NY |
070223000110 | FIDELIS (01) | NY |
10072104 | CDPHP (01) | NY |
200048 | SENIOR WHOLE HEALTH (01) | NY |
394892 | MVP (01) | NY |
5191C1 | EMPIRE BC (01) | NY |
7309558 | AETNA (01) | NY |
74563 | GHI/HMO (01) | NY |
H83783 | (02) | NY |