Member Dues | Independent Doctors of New York

Dues

Please fill out this form to process your dues payment. Dues are $500/year - and if you pay by credit card 3.99% processing charge will be added to the amount.

Name*
First Last
Current Email*
Card Number*
Please enter your card number.
Expiration Month*
Please enter the month as a number (ie. March as 3)
Expiration Year*
Please enter the expiration year.
cid*
Please enter the cid code usually found on the reverse of your card. This can be either a 3 didget or 4 didget code.
Current Billing Address*
Street Address Address Line 2 City State ZIP Code
Authorization*
By checking this box you are allowing the IDNY to process the member due fee with the card information being submitted.
- I Authorize the IDNY to process the member due fee.
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