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General NPI Number Information
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NPI Number | 1134113889
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Entity Type | Individual
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Provider Name | PATRICK J CONNOLLY M.D.
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Gender | Male
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Dates
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Enumeration Date | 09/08/2005
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Last Update Date | 02/21/2025
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Provider Practice Location Address
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Address Line | 3400 SPRUCE STREET 3 SILVERSTEIN BLDG.
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City | PHILADELPHIA
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State | PA
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Zip | 19104-4206
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Country | US
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Telephone | 215-662-3487
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Fax | 215-349-5534
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Provider Business Mailing Address
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Address Line | 1865 ROUTE 70 EAST
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City | CHERRY HILL
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State | NJ
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Zip | 08003-2013
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Country | US
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Telephone | 215-662-3487
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Fax | 215-349-5534
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207T00000X
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Taxonomy Name | Neurological Surgery Physician
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License Number | MD430407
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 207T00000X
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Taxonomy Name | Neurological Surgery Physician
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License Number | 25MA08681400
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License Number State | NJ
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