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Individual
MR. MICHAEL CHARLES CONNELL
Active
Individual
MR. MICHAEL CHARLES CONNELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A.
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
002970
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
002970
NYS LICENSE
NY
Enumeration date
12/06/2007
Last updated
06/16/2018
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