Active NPI
Brian Connolly, MD
- Family Medicine Physician
- Malone, NY
National Provider Identifier
1497110688
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 210333
- Practice address
- 181 Brand Rd
Malone, NY 12953-2945 - Phone
- (518) 483-8411
- Fax
- (518) 483-8408
- NPI assigned
- Dec 15, 2015
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 210333 | NY | Primary |
Addresses
Primary practice location
181 Brand Rd
Malone, NY 12953-2945
Mailing address
181 Brand Rd
Malone, NY 12953-2945
Phone (518) 483-8411
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
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 210333 | NY | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1450137600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1450137600000",
"number": "1497110688",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "181 BRAND RD",
"city": "MALONE",
"state": "NY",
"postal_code": "129532945",
"telephone_number": "518-483-8411",
"fax_number": "518-483-8408"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "181 BRAND RD",
"city": "MALONE",
"state": "NY",
"postal_code": "129532945",
"telephone_number": "518-483-8411",
"fax_number": "518-483-8408"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CONNOLLY",
"first_name": "BRIAN",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-12-15",
"last_updated": "2015-12-15",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "NY",
"license": "210333",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Malone, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.