Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 553341 | CT |
Y | 2080P0203X | Pediatric Critical Care Doctor | 553341 | CT |
NPI | 1265879266 |
---|---|
Provider Name | Tanya Donahou Murtha |
First Address | New Haven, CT 06520-8064 |
Second Address | New Haven, CT 06510 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/05/2013 |
Last Update Date | 13/01/2020 |