BRIAN CONNELLY (NPI# 1124103106) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124103106 |
| Entity Type | Individual |
| Full Name | BRIAN CONNELLY |
| Credential | MD |
| Practice Address |
223 N Van Dien Ave Ridgewood NJ 07450-2726 |
| Mailing Address |
Po Box 630 Franklin Lakes NJ 07417-0630 |
| Practice Telephone | 2018479403 |
| Practice Fax Number | 2018470059 |
| Mailing Telephone | 2018479403 |
| Mailing Fax Number | 2018470059 |
| Enumeration Date | 2006-10-26 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | MA05509500 | NJ | Other Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790157808 | Brian Connelly | Physical Therapy Assistant | 1803 Research Blvd, Suite 101, Rockville, MD 20850-3155 | 2015-10-28 |
| 1366868218 | Brian Connelly | Psychiatric Unit | 27 Cheryl Dr, Shoreham, NY 11786-2356 | 2014-03-14 |
| 1508486960 | Brian E Connelly | Specialist/Technologist, Other | 13100 Fort King Rd, Dade City, FL 33525-5294 | 2020-04-25 |
| 1366735557 | Brian Connelly | Specialist/Technologist, Other | 369 W 1st St, Dayton, OH 45402-3095 | 2011-05-19 |
| Street Address |
223 N VAN DIEN AVE |
| City | RIDGEWOOD |
| State | NJ |
| Zip Code | 07450-2726 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306840913 | Donna Mae Rudesyle | Nurse Practitioner | 223 N Van Dien Ave, Ridgewood, NJ 07450-2726 | 2005-06-10 |
| 1942801956 | Kelly Kennedy | Nurse Practitioner | 223 N Van Dien Ave, Ridgewood, NJ 07450-2726 | 2020-11-05 |
| 1649889858 | Barbara Abboud | Pharmacist | 223 N Van Dien Ave, Ridgewood, NJ 07450-2726 | 2020-07-24 |
| 1326668930 | Gita Natovich | Pharmacist | 223 N Van Dien Ave, Ridgewood, NJ 07450-2726 | 2020-04-23 |
| 1255975926 | Gertrude Patria Borja | Nurse Practitioner | 223 N Van Dien Ave, Ridgewood, NJ 07450-2726 | 2019-11-05 |
| 1386209229 | Benita Shaji Varghese | Nurse Practitioner | 223 N Van Dien Ave, Ridgewood, NJ 07450-2726 | 2019-05-07 |
| 1750851481 | Joe Juliano | Dietitian, Registered | 223 N Van Dien Ave, Ridgewood, NJ 07450-2726 | 2018-11-26 |
| 1558857748 | Amanda Ukleja | Physician Assistant | 223 N Van Dien Ave, Ridgewood, NJ 07450-2726 | 2018-07-10 |
| 1528597218 | Leah Serviano | Registered Nurse | 223 N Van Dien Ave, Ridgewood, NJ 07450-2726 | 2017-06-07 |
| 1306377569 | The Valley Hospital Inc. | Pharmacy | 223 N Van Dien Ave, Ridgewood, NJ 07450-2726 | 2017-03-21 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023675857 | Children's Aid and Family Services, Inc. | Behavioral Analyst | 213 Larue Road, W. Milford, NJ 07450 | 2019-05-28 |
| 1962065979 | Corey Chan | Student in an Organized Health Care Education/Training Program | 550 Lynn St, Ridgewood, NJ 07450 | 2019-04-16 |
| 1679058200 | Raymond Hawash | Pharmacist | 223 North Van Dien Ave, Ridgewood, NJ 07450 | 2018-09-28 |
| 1548771967 | Leonard Swerdlof | Dentist | 160 S Broad St, Ridgewood, NJ 07450 | 2017-10-12 |
| 1336671114 | Camp Sunshine and Camp Snowflake, Inc. | Respite Care | 1133 East Ridgewood Avenue, Ridgewood, NJ 07450 | 2017-03-30 |
| 1952764862 | Elysium Aesthetics and Vein Care, Inc | Radiology | 400 State Route 17, Ridgewood, NJ 07450 | 2016-03-30 |
| 1780077362 | Paul Walter Dasher | Psychologist | 76 West Ridgewood Avenue, Ridgewood, NJ 07450 | 2015-03-06 |
| 1255750071 | Myron Frank Lesh | Pharmacist | 305 E. Ridgewood Ave., Ridgewood, NJ 07450 | 2014-04-09 |
| 1649612912 | Jane Worthman-leva | Nutritionist | 357 South Irving St, Ridgewood, NJ 07450 | 2013-07-26 |
| 1427398858 | Life Opportunities Unlimited A Non Profit Corp. | Day Training, Developmentally Disabled Services | 75 North Maple Ave, Suite 104, Ridgewood, NJ 07450 | 2013-02-21 |
| Find all providers in zip 07450 | ||||
| Taxonomy Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326692096 | Deidre Ippolito | Specialist | 1864 Putnam Ave Apt 1r, Ridgewood, NY 11385-4314 | 2019-07-30 |
| 1497222079 | Karen Villacres | Specialist | 506 Grandview Ave Apt 2r, Ridgewood, NY 11385-1996 | 2018-10-31 |
| 1144713306 | Lilibeth Acosta | Specialist | 1627 Cornelia St, Ridgewood, NY 11385-4711 | 2018-06-12 |
| 1578065249 | Msan Medical Care PC | Specialist | 6861 Fresh Pond Rd, Ridgewood, NY 11385-5263 | 2018-03-08 |
| 1851807168 | Ailee Wiscovitch | Specialist | 1820 Cornelia St, Ridgewood, NY 11385-4900 | 2017-12-21 |
| 1386167005 | Kristen Naletilic | Specialist | 1835 Summerfield Street, Ridgewood, NY 11385 | 2017-07-25 |
| 1235672296 | American Healthcare Partners | Specialist | 38 E Ridgewood Ave # 200, Ridgewood, NJ 07450-3808 | 2016-11-23 |
| 1841743887 | Learning Steps Inc. | Specialist | 58-25 69 Ave, Ridgewood, NY 11385 | 2016-07-26 |
| 1639538598 | Yllka Tupi | Specialist | 2055 Gates Ave Apt 2l, Ridgewood, NY 11385-3030 | 2016-02-19 |
| 1609257732 | Robert Foerster | Specialist | 6135 Madison St, Apt 3l, Ridgewood, NY 11385-4038 | 2015-06-15 |
| Find all providers in RIDGEWOOD | ||||
Please comment or provide details below to improve the information on BRIAN CONNELLY.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.