Individual
LISA O'DONOVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
555 WILLARD AVE, NEWINGTON, CT 06111-2631
(866) 808-7921
Mailing address
555 WILLARD AVE, NEWINGTON, CT 06111-2631
(866) 808-7921
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
70764
CT
Other
Enumeration date
05/07/2019
Last updated
08/24/2023
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