Provider Demographics
NPI:1730187170
Name:DENSEL, DONNA LYNN (MD)
Entity type:Individual
Prefix:DR
First Name:DONNA
Middle Name:LYNN
Last Name:DENSEL
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 1:4 DEARFIELD DR
Mailing Address - Street 2:
Mailing Address - City:GREENWICH
Mailing Address - State:CT
Mailing Address - Zip Code:06831-5351
Mailing Address - Country:US
Mailing Address - Phone:203-869-3082
Mailing Address - Fax:203-869-6453
Practice Address - Street 1:4 DEARFIELD DR
Practice Address - Street 2:
Practice Address - City:GREENWICH
Practice Address - State:CT
Practice Address - Zip Code:06831-5351
Practice Address - Country:US
Practice Address - Phone:203-869-3082
Practice Address - Fax:203-869-6453
Is Sole Proprietor?:No
Enumeration Date:2005-07-11
Last Update Date:2010-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT039603207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
010039603CT01OtherANTHEM BCBS
2630271OtherAETNA
039603OtherCONNECTICARE
2V9097OtherHEALTHNET
408B81OtherEMPIRE
0481650001Medicare NSC
408B81OtherEMPIRE
F28632Medicare UPIN