Individual
MRS. KATHARINE BERNADETTE CONNOLLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, PA-C
Contact information
Practice address
267 GRANT STREET, BRIDGEPORT, CT 06610
(203) 384-3129
Mailing address
267 GRANT STREET, BRIDGEPORT, CT 06610
(203) 384-3129
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
002493
CT
Other
Enumeration date
10/18/2010
Last updated
05/27/2014
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