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Individual

PATRICIA MARY CONNELLY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
HHA, PCA

Contact information

Practice address
27 GOOSEBERRY RD, MASTIC BEACH, NY 11951-6335
(631) 316-9760
Mailing address
27 GOOSEBERRY RD, MASTIC BEACH, NY 11951-6335
(631) 316-9760

Taxonomy

Speciality
Code
Description
License number
State
3747P1801X
Personal Care Attendant
NY
374U00000X
Home Health Aide
Primary
00310022
NY

Other

Enumeration date
05/24/2012
Last updated
05/24/2012
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