Organization Name: | RUSSELL D. DONNELLY, M.D.,P.C. |
NPI Number: | 1780608364 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | RUSSELL D DONNELLY (PRESIDENT) |
Mailing Address: | 123 Summer St Suite 535 Worcester |
State: | MA US |
Postal Code: | 016081216 |
Phone Number: | 5083636363 |
Fax Number: | 5083636366 |
NPI Enumeration Date: | 07/27/2006 |
NPI Last Update Date: | 01/13/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | 56088 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MA |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |