Individual
BRIAN CONNOLLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MS,PT
Contact information
Practice address
2901 216TH ST, BAYSIDE, NY 11360-2810
(718) 281-8885
Mailing address
2901 216TH ST, BAYSIDE, NY 11360-2810
(718) 281-8885
Taxonomy
Speciality
Code
Description
License number
State
2251P0200X
Pediatric Physical Therapist
Primary
028119-1
NY
Other
Enumeration date
10/22/2008
Last updated
10/22/2008
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