Mary Madeline Connolly, OTRL

Primary specialty

Neurorehabilitation Occupational TherapistTaxonomy code 225XN1300X

License

4695 Issued in CA

Practice address

251 Landis Ave
Suite 201
Chula Vista, CA 91910

Phone

(619) 498-8450

Fax

(619) 498-8453

NPI assigned

May 1, 2007

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Ms. Lee Connolly Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1177977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1124249057",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "391 PROVO ST",
            "city": "EL CAJON",
            "state": "CA",
            "postal_code": "92019",
            "telephone_number": "619-447-8111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "251 LANDIS AVE",
            "address_2": "SUITE 201",
            "city": "CHULA VISTA",
            "state": "CA",
            "postal_code": "91910",
            "telephone_number": "619-498-8450",
            "fax_number": "619-498-8453"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONNOLLY",
        "first_name": "MARY",
        "middle_name": "MADELINE",
        "name_prefix": "Ms.",
        "credential": "OTRL",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XN1300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist, Neurorehabilitation",
            "state": "CA",
            "license": "4695",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LEE",
            "last_name": "CONNOLLY",
            "prefix": "MS.",
            "credential": "OTRL",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Hector Samuel Concepcion Jr.
• Jayrone Concepcion
• Karrisa Leticia Conchas
• Stephanie Lynne Conklin
• Connect the Dots Counseling
• Ashley Ann Connors
• Leah Lynn Conopio
• Katelyn Conrad
• Haley Conroy
• Mariana Therese Constable, MOTR/L

• Neurorehabilitation Occupational Therapist in Chula Vista, CA
• Providers in Chula Vista, CA by specialty
• Neurorehabilitation Occupational Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.