Most Relevant Information
Provider Data
| NPI Number: | 1003303181 |
| Provider Name: | MICHAEL CONNOLLY |
| Entity Type: | Individual |
| Taxonomy Code: | 390200000X |
| Specialty: | Student in an Organized Health Care Education/Training Program |
| License Number: |
Most Important Dates
| Enumeration Date: | 04/16/2018 |
| Last Updated: | 05/14/2021 |
Provider Practice Location
263 FARMINGTON AVE
FARMINGTON
CT
060301921
Practice Location Phone/Fax
| Phone: | 8606794733 |
| Fax: | 8606791316 |
Provider Mailing Location
263 FARMINGTON AVE
FARMINGTON
CT
060301921
Provider Mailing Phone/Fax
| Phone: | 8606792147 |
| Fax: | 8606794624 |