Provider Demographics
NPI:1508845306
Name:CIPOLLA, DONNA M (MD)
Entity Type:Individual
Prefix:DR
First Name:DONNA
Middle Name:M
Last Name:CIPOLLA
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:2139 SILAS DEANE HWY
Mailing Address - Street 2:CT GI, PC
Mailing Address - City:ROCKY HILL
Mailing Address - State:CT
Mailing Address - Zip Code:06067-2336
Mailing Address - Country:US
Mailing Address - Phone:860-257-4131
Mailing Address - Fax:860-257-4519
Practice Address - Street 1:300 WESTERN BLVD
Practice Address - Street 2:SUITE A
Practice Address - City:GLASTONBURY
Practice Address - State:CT
Practice Address - Zip Code:06033-4305
Practice Address - Country:US
Practice Address - Phone:860-657-1920
Practice Address - Fax:860-657-1925
Is Sole Proprietor?:No
Enumeration Date:2006-01-11
Last Update Date:2011-04-28
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CT034455207R00000X, 207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT001344556Medicaid
CT110006714Medicare ID - Type Unspecified
CT001344556Medicaid