Healthcare Provider Details

I. General information

NPI: 1285741611
Provider Name (Legal Business Name): VIRGINIA CONNOLLY APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: GINGER CONNOLLY APRN

II. Dates (important events)

Enumeration Date: 08/23/2006
Last Update Date: 02/26/2026
Certification Date: 02/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 S GREELEY AVE STE 302
CHAPPAQUA NY
10514-3346
US

IV. Provider business mailing address

1 S GREELEY AVE STE 302
CHAPPAQUA NY
10514-3346
US

V. Phone/Fax

Practice location:
  • Phone: 914-238-1699
  • Fax: 914-238-1695
Mailing address:
  • Phone: 914-238-1699
  • Fax: 914-238-1695

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number400534
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: