Individual
BRIAN CONNELLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CTRS
Contact information
Practice address
27 CHERYL DR, SHOREHAM, NY 11786-2356
(631) 849-4442
Mailing address
27 CHERYL DR, SHOREHAM, NY 11786-2356
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
273R00000X
Psychiatric Hospital Unit
—
—
Other
Enumeration date
03/14/2014
Last updated
03/14/2014
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