Christopher Thomas Connolly, RPH
Individual provider Active NPI Pharmacist · Newfane, NY
NPI 1336209683 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1336209683
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 045452 (NY)
- Practice address
- 2740 Main St
Newfane, NY 14108-1206 - Phone
- (716) 778-7422
- Fax
- (716) 778-5289
- NPI assigned
- Dec 9, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 045452 | NY | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Peterson Drug Company of Newfane Ny, Inc. | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 045452 | NY | Yes |
Addresses
Primary practice location
2740 Main St
Newfane, NY 14108-1206
Mailing address
5735 McKee Rd
Newfane, NY 14108-9612
Phone (716) 778-5529
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 045452 | Other | NY | STATE PHARMACY LICENSE |
Other providers in Newfane, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.