Provider Demographics
NPI:1144302696
Name:DONNELLY, PATRICK FRANCIS (CPO)
Entity type:Individual
Prefix:MR
First Name:PATRICK
Middle Name:FRANCIS
Last Name:DONNELLY
Suffix:
Gender:M
Credentials:CPO
Other - Prefix:MISS
Other - First Name:CARLA
Other - Middle Name:JEAN
Other - Last Name:DOYCHAK
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:CERTIFIED FITTER
Mailing Address - Street 1:85 BARNES RD STE 302
Mailing Address - Street 2:
Mailing Address - City:WALLINGFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06492-1832
Mailing Address - Country:US
Mailing Address - Phone:203-605-1725
Mailing Address - Fax:
Practice Address - Street 1:85 BARNES RD STE 302
Practice Address - Street 2:
Practice Address - City:WALLINGFORD
Practice Address - State:CT
Practice Address - Zip Code:06492-1832
Practice Address - Country:US
Practice Address - Phone:203-605-1725
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-20
Last Update Date:2017-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier