Provider Demographics
NPI:1447252663
Name:ENOCH, DONALD CHRISTOPHER (MD)
Entity type:Individual
Prefix:DR
First Name:DONALD
Middle Name:CHRISTOPHER
Last Name:ENOCH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:2649 STRANG BLVD STE 304
Mailing Address - Street 2:
Mailing Address - City:YORKTOWN HEIGHTS
Mailing Address - State:NY
Mailing Address - Zip Code:10598-2938
Mailing Address - Country:US
Mailing Address - Phone:914-739-0087
Mailing Address - Fax:914-737-1714
Practice Address - Street 1:334 UNDERHILL AVE
Practice Address - Street 2:STE 5A
Practice Address - City:YORKTOWN HEIGHTS
Practice Address - State:NY
Practice Address - Zip Code:10598-4556
Practice Address - Country:US
Practice Address - Phone:914-243-4780
Practice Address - Fax:914-243-4783
Is Sole Proprietor?:No
Enumeration Date:2005-06-01
Last Update Date:2022-12-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY179300207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01677949Medicaid
NY01677949Medicaid
NY79F231Medicare ID - Type Unspecified