| Doctor Name: | BRIAN CONNELLY |
| NPI Number: | 1366868218 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | CTRS |
| License Number: | |
| Business Practice Address: | 27 Cheryl Dr Shoreham, NY - 117862356 |
| Business Phone Number: | 6318494442 |
| Business Fax Number: | |
| Mailing Address: | 27 Cheryl Dr, SHOREHAM |
| State: | NY |
| Postal Code: | 117862356 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 03/14/2014 |
| NPI Last Update Date: | 03/14/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 273R00000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | |
| Taxonomy Type: | Hospital Units |
| Taxonomy Classification: | Psychiatric Unit |
| Taxonomy Specialization: | |
| Taxonomy Definition: | In general, a distinct unit of a hospital that provides acute or long-term care to emotionally disturbed patients, including patients admitted for diagnosis and those admitted for treatment of psychiatric problems on the basis of physicians |