Provider Demographics
NPI:1093120834
Name:CONNORS, PHILIP DONALD (MS)
Entity Type:Individual
Prefix:MR
First Name:PHILIP
Middle Name:DONALD
Last Name:CONNORS
Suffix:
Gender:M
Credentials:MS
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:330 BROOKLINE AVE
Mailing Address - Street 2:SHAPIRO 9
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02215-5400
Mailing Address - Country:US
Mailing Address - Phone:617-667-8813
Mailing Address - Fax:617-667-3205
Practice Address - Street 1:330 BROOKLINE AVE
Practice Address - Street 2:SHAPIRO 9
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02215-5400
Practice Address - Country:US
Practice Address - Phone:617-667-8813
Practice Address - Fax:617-667-3205
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-30
Last Update Date:2014-06-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MAPGC079170300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS