Organization
CONNOLLY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BAILEY HANSFORD (DIRECTOR - ELIGIBILITY)
(203) 423-1360
Entity
Organization
Contact information
Practice address
555 E NORTH LN STE 6020, CONSHOHOCKEN, PA 19428-2249
(203) 423-1360
Mailing address
555 E NORTH LN STE 6020, CONSHOHOCKEN, PA 19428-2249
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
—
—
Other
Enumeration date
12/02/2014
Last updated
12/02/2014
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