Individual
LISA DONOVAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
27 RED CROSS AVE, NEWPORT, RI 02840-3316
(860) 662-0273
Mailing address
27 RED CROSS AVE, NEWPORT, RI 02840-3316
(860) 662-0273
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
035538
CT
2084P0800X
Psychiatry Physician
Primary
MD15672
RI
2084P0804X
Child & Adolescent Psychiatry Physician
035538
CT
2084P0804X
Child & Adolescent Psychiatry Physician
MD15672
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
035538
CT LICENSE
CT
01
—
MD15672
MEDICAL LICENSE
RI
Enumeration date
03/31/2008
Last updated
01/22/2024
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