Individual
BROOKE MACKENZIE DONNELLAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2800 MAIN ST, BRIDGEPORT, CT 06606-4292
(203) 576-6000
Mailing address
26 HUNTS BROOK RD, QUAKER HILL, CT 06375-1009
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
6495
CT
Other
Enumeration date
11/20/2023
Last updated
03/27/2024
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