Individual
RYAN J DONOVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
20 YORK ST, CB-2041, NEW HAVEN, CT 06510-3220
(203) 688-4748
(203) 688-4740
Mailing address
20 YORK ST, NEW HAVEN, CT 06510-3220
(203) 688-4242
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
001289
CT
363AM0700X
Medical Physician Assistant
Primary
1289
CT
363AS0400X
Surgical Physician Assistant
001289
CT
Other
Enumeration date
04/25/2006
Last updated
05/22/2015
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