Individual provider Active NPI

Brian Connolly, RPH

  • Pharmacist
  • Bronx, NY
National Provider Identifier
1447898440
Registry record updated Dec 20, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
032412 Issued in NY
Practice address
3424 Kossuth Ave
Bronx, NY 10467-2489
Phone
(718) 519-3575
Fax
(718) 519-2496
NPI assigned
Dec 20, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 20, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 032412 NY Primary

Addresses

Primary practice location

3424 Kossuth Ave
Bronx, NY 10467-2489

Mailing address

3424 Kossuth Ave
Bronx, NY 10467-2489
Phone (718) 519-3575

Other identifiers 1

IdentifierTypeStateIssuer
00246171MedicaidNY

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL brian.connolly@nychhc.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
032412NYMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1576800000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576800000000",
    "number": "1447898440",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3424 KOSSUTH AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104672489",
            "telephone_number": "718-519-3575",
            "fax_number": "718-519-2496"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3424 KOSSUTH AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104672489",
            "telephone_number": "718-519-3575",
            "fax_number": "718-519-2496"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONNOLLY",
        "first_name": "BRIAN",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-12-20",
        "last_updated": "2019-12-20",
        "certification_date": "2019-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NY",
            "license": "032412",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00246171",
            "state": "NY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "brian.connolly@nychhc.org",
            "affiliation": "N",
            "endpointDescription": "Work Email",
            "address_1": "3424 Kossuth Ave",
            "city": "Bronx",
            "state": "NY",
            "country_code": "US",
            "postal_code": "104672489",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2019; 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.