Individual provider Active NPI

Maureen Theresa Donohue

  • Specialist
  • Bronx, NY
National Provider Identifier
1639628613
Registry record updated Dec 4, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
1186746171 Issued in NY
Practice address
329 E 149TH St
Bronx, NY 10451-5601
Phone
(718) 769-2698
Fax
(718) 943-7035
NPI assigned
Oct 1, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 4, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Early Intervention Provider Agency 252Y00000X
Specialist 174400000X 1186746171 NY Primary

Addresses

Primary practice location

329 E 149TH St
Bronx, NY 10451-5601

Mailing address

191 73Rd St Apt 257
Brooklyn, NY 11209-2257
Phone (315) 573-0319

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
1186746171NYMDSpecialist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1475280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1575417600000",
    "number": "1639628613",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "191 73RD ST APT 257",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112092257",
            "telephone_number": "315-573-0319"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "329 E 149TH ST",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104515601",
            "telephone_number": "718-769-2698",
            "fax_number": "718-943-7035"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DONOHUE",
        "first_name": "MAUREEN",
        "middle_name": "THERESA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-10-01",
        "last_updated": "2019-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "252Y00000X",
            "taxonomy_group": "",
            "desc": "Early Intervention Provider Agency",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": "1186746171",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.