Provider Demographics
NPI:1336898303
Name:DONNA HEFFERNAN MD PLLC
Entity type:Organization
Organization Name:DONNA HEFFERNAN MD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:A
Authorized Official - Last Name:STEVENSON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:518-346-3100
Mailing Address - Street 1:PO BOX 3203
Mailing Address - Street 2:
Mailing Address - City:SCHENECTADY
Mailing Address - State:NY
Mailing Address - Zip Code:12303-0203
Mailing Address - Country:US
Mailing Address - Phone:518-346-3100
Mailing Address - Fax:877-583-1284
Practice Address - Street 1:63 EAST RD
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:NY
Practice Address - Zip Code:12180-6860
Practice Address - Country:US
Practice Address - Phone:518-346-3100
Practice Address - Fax:877-583-1284
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-18
Last Update Date:2025-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY1336898303OtherHIGHMARK
NY1336898303OtherGEHA
NY1336898303OtherGHI
NY1336898303OtherWELLCARE AMERICAN PROGRESSIVE
NY1336898303OtherCDPHP
NY02425056Medicaid
NY1336898303OtherMVP HEALTH PLAN
NY1336898303OtherAETNA
NY01666792112180000OtherTRICARE
NY1336898303OtherEMBLEM HEALTH
NY1336898303OtherHUMANA
NY1336898303OtherUNITED HEALTHCARE