Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | 126039 | OH |
Y | 207XS0106X | Orthopaedic Hand Surgeon | 054982 | CT |
NPI | 1093041287 |
---|---|
Provider Name | Kenneth William Donohue |
First Address | New Haven, CT 06520-8071 |
Second Address | New Haven, CT 06519-1369 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/10/2009 |
Last Update Date | 12/08/2016 |