Individual
RYAN CONNOLLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
6620 FLY RD, STE 200, EAST SYRACUSE, NY 13057-9791
(315) 464-4472
(315) 464-5229
Mailing address
6620 FLY RD, STE 200, EAST SYRACUSE, NY 13057-9791
(315) 464-4472
(315) 464-5229
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
018048
NY
Other
Enumeration date
09/29/2014
Last updated
09/29/2014
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