Provider Demographics
NPI:1417948761
Name:CONNERY, CLIFF P (MD)
Entity Type:Individual
Prefix:DR
First Name:CLIFF
Middle Name:P
Last Name:CONNERY
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1351 ROUTE 55
Mailing Address - Street 2:SUITE 200
Mailing Address - City:LAGRANGEVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:12540-5108
Mailing Address - Country:US
Mailing Address - Phone:845-475-9661
Mailing Address - Fax:845-475-9938
Practice Address - Street 1:45 READE PL
Practice Address - Street 2:DYSON CENTER, 3RD FL
Practice Address - City:POUGHKEEPSIE
Practice Address - State:NY
Practice Address - Zip Code:12601
Practice Address - Country:US
Practice Address - Phone:845-483-6920
Practice Address - Fax:845-483-6922
Is Sole Proprietor?:No
Enumeration Date:2005-11-03
Last Update Date:2019-10-15
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Provider Licenses
StateLicense IDTaxonomies
NY164704208600000X, 2086S0102X, 208G00000X, 2086X0206X
CT164704208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086X0206XAllopathic & Osteopathic PhysiciansSurgerySurgical Oncology
No208600000XAllopathic & Osteopathic PhysiciansSurgery
No2086S0102XAllopathic & Osteopathic PhysiciansSurgerySurgical Critical Care
No208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01170254Medicaid
NY011702TMedicaid
NYA400096639Medicare PIN
10L191Medicare ID - Type Unspecified
F75214Medicare UPIN