Healthcare Provider Details

I. General information

NPI: 1164401741
Provider Name (Legal Business Name): BRIAN P CONNOLLY MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/12/2006
Last Update Date: 04/09/2026
Certification Date: 04/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

160 SAWGRASS DR SUITE 200
ROCHESTER NY
14620-4648
US

IV. Provider business mailing address

160 SAWGRASS DR STE 200
ROCHESTER NY
14620-4655
US

V. Phone/Fax

Practice location:
  • Phone: 585-442-3411
  • Fax: 585-442-9550
Mailing address:
  • Phone: 585-442-3411
  • Fax: 585-442-9550

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207WX0107X
TaxonomyRetina Specialist (Ophthalmology) Physician
License Number237374
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number237374
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: