Provider Demographics
NPI:1922286566
Name:CONNERS, BRIAN (RPH)
Entity Type:Individual
Prefix:
First Name:BRIAN
Middle Name:
Last Name:CONNERS
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:596 US ROUTE 11
Mailing Address - Street 2:
Mailing Address - City:TULLY
Mailing Address - State:NY
Mailing Address - Zip Code:13159-9410
Mailing Address - Country:US
Mailing Address - Phone:315-696-8796
Mailing Address - Fax:
Practice Address - Street 1:437 ELECTRONICS PKWY
Practice Address - Street 2:
Practice Address - City:LIVERPOOL
Practice Address - State:NY
Practice Address - Zip Code:13088-6001
Practice Address - Country:US
Practice Address - Phone:315-453-1750
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-02-06
Last Update Date:2019-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY050607183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist