Provider Demographics
NPI:1497735799
Name:DONNELLY, ALYSSA ANN (MD)
Entity Type:Individual
Prefix:DR
First Name:ALYSSA
Middle Name:ANN
Last Name:DONNELLY
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:99 EAST RIVER DRIVE
Mailing Address - Street 2:5TH FLOOR
Mailing Address - City:EAST HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06108-7301
Mailing Address - Country:US
Mailing Address - Phone:860-282-4022
Mailing Address - Fax:860-282-0834
Practice Address - Street 1:80 SEYMOUR STREET
Practice Address - Street 2:
Practice Address - City:HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06141
Practice Address - Country:US
Practice Address - Phone:860-545-2117
Practice Address - Fax:860-545-1784
Is Sole Proprietor?:No
Enumeration Date:2006-01-20
Last Update Date:2021-04-16
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CT047392207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CTD400003947Medicare PIN
CTD400003691Medicare PIN