Healthcare Provider Details

I. General information

NPI: 1336189281
Provider Name (Legal Business Name): TERRENCE K DONAHUE MD LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/08/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

40 HART STREET BLDG D
NEW BRITAIN CT
06052
US

IV. Provider business mailing address

40 HART STREET BLDG D
NEW BRITAIN CT
06052
US

V. Phone/Fax

Practice location:
  • Phone: 860-826-5288
  • Fax: 860-225-9519
Mailing address:
  • Phone: 860-826-5288
  • Fax: 860-225-9519

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number001357
License Number StateCT
# 2
Primary TaxonomyY
Taxonomy Code207XS0106X
TaxonomyOrthopaedic Hand Surgery Physician
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberID044382
License Number StateCT
# 4
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number028945
License Number StateCT

VIII. Authorized Official

Name: MR. TERRENCE K DONAHUE
Title or Position: MANAGING MEMBER
Credential: MD
Phone: 860-826-5288