Individual
MICHAEL D DEVANNEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
40 HART ST, NEW BRITAIN, CT 06052-1743
(860) 549-3210
(860) 247-3803
Mailing address
270 FARMINGTON AVE, SUITE 102, FARMINGTON, CT 06032-1909
(860) 549-8276
(860) 674-8084
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2308
CT
363AM0700X
Medical Physician Assistant
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1164756383
NPI
CT
Enumeration date
09/21/2009
Last updated
09/05/2019
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