Doctor Name: | DR. DEVORAH DONNELL |
NPI Number: | 1093196941 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.D. |
License Number: | 264721 |
Business Practice Address: | 195 Canal St Malden, MA - 021486701 |
Business Phone Number: | 7813380500 |
Business Fax Number: | |
Mailing Address: | 44 Indian Spring Rd, WOODSTOCK |
State: | CT |
Postal Code: | 062812606 |
Phone Number: | 8608106971 |
Fax Number: | |
NPI Enumeration Date: | 06/17/2015 |
NPI Last Update Date: | 06/17/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 390200000X |
License Number: | 264721 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MA |
Taxonomy Type: | Student, Health Care |
Taxonomy Classification: | Student in an Organized Health Care Education/Training Program |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |