Organization
MARY CONNOLLY LMSW PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MARY CONNOLLY LMSW (SOCIAL WORKER)
(718) 344-4981
Entity
Organization
Contact information
Practice address
92 EVERGREEN ST, STATEN ISLAND, NY 10308-1812
(718) 344-4981
Mailing address
92 EVERGREEN ST, STATEN ISLAND, NY 10308-1812
(718) 344-4981
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
075265
NY
Other
Enumeration date
06/25/2012
Last updated
06/25/2012
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