Provider Demographics
NPI:1184649600
Name:CONNELL, CINDYLOU F (MD)
Entity Type:Individual
Prefix:
First Name:CINDYLOU
Middle Name:F
Last Name:CONNELL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:CINDYLOU
Other - Middle Name:F
Other - Last Name:ROSSANA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:4300 LONDONDERRY RD STE 302
Mailing Address - Street 2:
Mailing Address - City:HARRISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17109-5317
Mailing Address - Country:US
Mailing Address - Phone:717-724-6780
Mailing Address - Fax:
Practice Address - Street 1:4300 LONDONDERRY RD STE 302
Practice Address - Street 2:
Practice Address - City:HARRISBURG
Practice Address - State:PA
Practice Address - Zip Code:17109-5317
Practice Address - Country:US
Practice Address - Phone:717-724-6780
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-13
Last Update Date:2023-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-063388207RH0003X
PAMD442955207RH0003X, 207RX0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
No207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH741843OtherBUCKEYE
000000224388OtherUNISON
363441OtherWELLCARE
4672781OtherAETNA
000000539539OtherANTHEM
OH0920034Medicaid
OH741843OtherBUCKEYE
F56143Medicare UPIN
OHP00603620Medicare PIN
OH0920034Medicaid