Healthcare Provider Details

I. General information

NPI: 1265879266
Provider Name (Legal Business Name): TANYA DONAHOU MURTHA M.D., M.P.H.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/30/2013
Last Update Date: 08/15/2022
Certification Date: 08/09/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 PARK ST
NEW HAVEN CT
06510
US

IV. Provider business mailing address

333 CEDAR ST YALE-NEW HAVEN HOSPITAL
NEW HAVEN CT
06520-8064
US

V. Phone/Fax

Practice location:
  • Phone: 203-688-2323
  • Fax:
Mailing address:
  • Phone: 203-785-4651
  • Fax: 203-688-1617

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number553341
License Number StateCT
# 2
Primary TaxonomyN
Taxonomy Code2080P0203X
TaxonomyPediatric Critical Care Medicine Physician
License NumberMD18629
License Number StateRI
# 3
Primary TaxonomyY
Taxonomy Code2080P0203X
TaxonomyPediatric Critical Care Medicine Physician
License Number553341
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: