Individual
BRIAN CONNELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
77 MEDFORD AVE, PATCHOGUE, NY 11772-1281
(631) 758-1910
Mailing address
712 MAIN ST, ISLIP, NY 11751-3620
(631) 666-3939
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
045111
NY
Other
Enumeration date
11/14/2019
Last updated
11/14/2019
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