Individual
MICHAEL GERARD CONNOLLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LP
Contact information
Practice address
214 W 97TH ST, NEW YORK, NY 10025-5620
(646) 479-2573
Mailing address
2 RIVERSIDE DR APT 5D, NEW YORK, NY 10023-2526
(646) 479-2573
Taxonomy
Speciality
Code
Description
License number
State
102L00000X
Psychoanalyst
Primary
1023
NY
Other
Enumeration date
05/19/2018
Last updated
05/19/2018
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