Provider Demographics
NPI:1720466220
Name:DONATO, MINELVA ROMELIA NANTON (MD, PHD)
Entity type:Individual
Prefix:DR
First Name:MINELVA
Middle Name:ROMELIA NANTON
Last Name:DONATO
Suffix:
Gender:F
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 SOUTH ST STE 102
Mailing Address - Street 2:
Mailing Address - City:RIDGEFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06877-4125
Mailing Address - Country:US
Mailing Address - Phone:032-083-2302
Mailing Address - Fax:203-208-3231
Practice Address - Street 1:10 SOUTH ST STE 102
Practice Address - Street 2:
Practice Address - City:RIDGEFIELD
Practice Address - State:CT
Practice Address - Zip Code:06877-4125
Practice Address - Country:US
Practice Address - Phone:203-208-3230
Practice Address - Fax:203-208-3231
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-15
Last Update Date:2023-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT68185207Q00000X
MN60839207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty