Provider Demographics
NPI:1497772958
Name:CONNERS, MICHAEL S (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:S
Last Name:CONNERS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3400 TECHNOLOGY DRIVE
Mailing Address - Street 2:SUITE 107
Mailing Address - City:EAST SETAUKET
Mailing Address - State:NY
Mailing Address - Zip Code:11733
Mailing Address - Country:US
Mailing Address - Phone:631-751-2020
Mailing Address - Fax:631-444-0912
Practice Address - Street 1:3400 NESCONSET HWY
Practice Address - Street 2:TECHNOLOGY DRIVE, SUITE 107
Practice Address - City:EAST SETAUKET
Practice Address - State:NY
Practice Address - Zip Code:11733-3327
Practice Address - Country:US
Practice Address - Phone:631-751-2020
Practice Address - Fax:631-444-0912
Is Sole Proprietor?:No
Enumeration Date:2006-07-17
Last Update Date:2016-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY245471207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
H15941Medicare UPIN
NY253222L511Medicare PIN