Individual
MS. MARY CONNOLLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
15 BERWICK ST, WEST ROXBURY, MA 02132-4217
(617) 477-3546
(617) 971-3783
Mailing address
170 MORTON ST, JAMAICA PLAIN, MA 02130-3735
(617) 522-8110
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
36
MA
Other
Enumeration date
09/27/2006
Last updated
05/23/2017
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