Provider Demographics
NPI:1114442936
Name:CONNOLLY, CAOILFHIONN MARIE (MB BCH BAO, MSC)
Entity Type:Individual
Prefix:DR
First Name:CAOILFHIONN
Middle Name:MARIE
Last Name:CONNOLLY
Suffix:
Gender:F
Credentials:MB BCH BAO, MSC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:707 PRESIDENT ST APT 438
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21202-4477
Mailing Address - Country:US
Mailing Address - Phone:929-259-2453
Mailing Address - Fax:
Practice Address - Street 1:1800 ORLEANS ST
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21287-0010
Practice Address - Country:US
Practice Address - Phone:410-955-2834
Practice Address - Fax:410-955-1545
Is Sole Proprietor?:No
Enumeration Date:2017-08-14
Last Update Date:2017-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program