Provider Demographics
NPI:1558822551
Name:ARQUETTE, CONNOR PATRICK
Entity Type:Individual
Prefix:
First Name:CONNOR
Middle Name:PATRICK
Last Name:ARQUETTE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24 CAMBRIDGE CT
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:NY
Mailing Address - Zip Code:14086-9356
Mailing Address - Country:US
Mailing Address - Phone:716-989-7411
Mailing Address - Fax:
Practice Address - Street 1:24 CAMBRIDGE CT
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:NY
Practice Address - Zip Code:14086-9356
Practice Address - Country:US
Practice Address - Phone:716-989-7411
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-31
Last Update Date:2019-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program