Connolly, Mark William

Connolly, Mark William is an sole proprietor health care provider with primary practice located at 252 S 4Th St , Lebanon PA 17042-6111. He recently has only one registered license in Allopathic & Osteopathic Physicians / Thoracic Surgery (Cardiothoracic Vascular Surgery), which is considered as his primary health care specialty. Connolly, Mark William can be contacted via phone (717) 270-3751.

Contact Information

Primary practice address
252 S 4Th St Lebanon PA 17042-6111
Phone: (717) 270-3751
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Thoracic Surgery (Cardiothoracic Vascular Surgery) 208G00000X MA74369 New Jersey

Profile Details

NPI number 1326010612
LBN Legal business name Connolly, Mark William
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Feb 2nd, 2006
Last updated Jul 15th, 2024 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1326010612 NPPES
New Jersey Other 060268 MADICARE ID-TYPE UNSPECIFIED
New Jersey MEDICAID 6504906 MADICARE ID-TYPE UNSPECIFIED

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