Individual
SUSAN L DONNELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
80 SEYMOUR ST, HARTFORD HOSPITAL ORTHOPEDICS DEPT, HARTFORD, CT 06102-8000
(860) 545-2245
Mailing address
PO BOX 40000, DEPT 634 HARTFORD HOSPITAL PROFESSIONAL SERVICES, HARTFORD, CT 06151-0001
(860) 545-7602
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
000935
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003009354
—
CT
Enumeration date
10/05/2006
Last updated
08/06/2008
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