Provider Demographics
NPI:1649322686
Name:DONKA, ABEL A (MD)
Entity type:Individual
Prefix:
First Name:ABEL
Middle Name:A
Last Name:DONKA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:NIANTIC
Mailing Address - State:CT
Mailing Address - Zip Code:06357-2340
Mailing Address - Country:US
Mailing Address - Phone:860-739-4431
Mailing Address - Fax:860-739-9461
Practice Address - Street 1:22 W MAIN ST
Practice Address - Street 2:
Practice Address - City:NIANTIC
Practice Address - State:CT
Practice Address - Zip Code:06357-2340
Practice Address - Country:US
Practice Address - Phone:860-739-4431
Practice Address - Fax:860-739-9461
Is Sole Proprietor?:No
Enumeration Date:2007-01-18
Last Update Date:2008-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT044908207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT001449083Medicaid
CT010044908CT01OtherANTHEM OF CT
2V9952OtherHEALTH NET
CT001449083Medicaid
CTP00462881Medicare PIN