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Individual

MR. WALTER GERARD DONNELLY JR.

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
29 HOSPITAL HILL RD, SUITE #1100, SHARON, CT 06069
(860) 364-5646
(860) 364-5265
Mailing address
PO BOX 679, SHARON, CT 06069-0679
(860) 364-5646
(860) 364-5265

Taxonomy

Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
018261
CT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00508470
NY
01
010018261CT01
ANTHEM BLUE CROSS BLUE SH
01
040220
HEALTH NET
Enumeration date
08/15/2006
Last updated
07/08/2007
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