Eric Connolly, LPN

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

308390 Issued in NY

Practice address

5 Norway Pine Dr
Medford, NY 11763-4206

Phone

(516) 806-7686

Fax

(631) 569-2209

NPI assigned

Nov 18, 2011

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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": "1321574400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1321574400000",
    "number": "1376810317",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 NORWAY PINE DR",
            "city": "MEDFORD",
            "state": "NY",
            "postal_code": "117634206",
            "telephone_number": "516-806-7686",
            "fax_number": "631-569-2209"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 NORWAY PINE DR",
            "city": "MEDFORD",
            "state": "NY",
            "postal_code": "117634206",
            "telephone_number": "516-806-7686",
            "fax_number": "631-569-2209"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONNOLLY",
        "first_name": "ERIC",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-11-18",
        "last_updated": "2011-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "308390",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kenya D Clinton-Coles
• Cole Chiropractic PC
• Frances Colon, LCSW
• Concern for Independent Living, Inc.
• Erin Kelly Connell, MS
• Maeve Connolly
• Thomas Graham Conway, OTR/L
• Kristina Corbett, LMSW
• Lauren Brooke Corin
• Jodi Y Corley, OD

• Licensed Practical Nurse in Medford, NY
• Providers in Medford, NY by specialty
• Licensed Practical Nurse in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2011; 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.