Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RG0100X | Gastroenterologist | OS012366 | PA |
NPI | 1043494081 |
---|---|
Provider Name | Dr. Sean A. Connelly |
First Address | Beaver Falls, PA 15010-1634 |
Second Address | Beaver Falls, PA 15010-1634 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/12/2007 |
Last Update Date | 11/06/2012 |