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Individual

STEPHAN MAXWELL DONIS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DPM

Contact information

Practice address
270 FARRAGUT AVE, HASTINGS ON HUDSON, NY 10706-3518
(914) 674-0479
Mailing address
270 FARRAGUT AVE, HASTINGS ON HUDSON, NY 10706-3518
(914) 674-0479

Taxonomy

Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
P2179
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
01650435
NY
01
133069342
TAX ID
01
432921
AETNA
01
P00221353
RAILROAD MEDICARE
01
P22262
EMPIRE BCBS
NY
Enumeration date
01/05/2007
Last updated
05/22/2008
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