Doctor Name: | BRIDGET CONNOLLY |
NPI Number: | 1023444775 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | N.P. |
License Number: | F332108 |
Business Practice Address: | 2529 New York 52 Hopewell Junction, NY - 12533 |
Business Phone Number: | 8452270123 |
Business Fax Number: | |
Mailing Address: | 36 Grist Mill Ln, PLEASANT VALLEY |
State: | NY |
Postal Code: | 125697386 |
Phone Number: | 8456358216 |
Fax Number: | |
NPI Enumeration Date: | 09/25/2013 |
NPI Last Update Date: | 09/25/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | F332108 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |