Provider Demographics
NPI:1942209580
Name:MANASSEH, DONNA-MARIE (MD)
Entity Type:Individual
Prefix:
First Name:DONNA-MARIE
Middle Name:
Last Name:MANASSEH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:32 STRAWBERRY HILL CT
Mailing Address - Street 2:SUITE #8
Mailing Address - City:STAMFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06902-2594
Mailing Address - Country:US
Mailing Address - Phone:203-276-4255
Mailing Address - Fax:
Practice Address - Street 1:32 STRAWBERRY HILL CT
Practice Address - Street 2:SUITE #8
Practice Address - City:STAMFORD
Practice Address - State:CT
Practice Address - Zip Code:06902-2594
Practice Address - Country:US
Practice Address - Phone:203-276-4255
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-07-15
Last Update Date:2007-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT043744208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CTP3668000OtherOXFORD
CTP3782239OtherOXFORD
CT1182485OtherAETNA
CT7961507OtherAETNA
CTTINOtherUHC
CT010043744CT01OtherANTHEM BCBS
CT2V7635OtherHEALTH NET
CT4197554OtherCIGNA
CT2V9215OtherHEALTH NET
CT1182485OtherAETNA
CT2V7635OtherHEALTH NET
CTTINOtherUHC