Individual
DR. BRENDA JEAN CONNOLLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
4038 WEST RD, CORTLAND, NY 13045-1842
(607) 758-3008
(607) 758-3019
Mailing address
17 MAIN ST, SUITE 302, CORTLAND, NY 13045-6606
(607) 753-3797
(607) 753-6677
Taxonomy
Speciality
Code
Description
License number
State
207QA0505X
Adult Medicine Physician
Primary
219374
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02457596
—
NY
Enumeration date
10/03/2006
Last updated
08/02/2013
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