Provider Demographics
NPI:1205308251
Name:CONNAUGHTY, AUSTIN JAMES (DC)
Entity type:Individual
Prefix:
First Name:AUSTIN
Middle Name:JAMES
Last Name:CONNAUGHTY
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:142 BOSTON POST RD
Mailing Address - Street 2:
Mailing Address - City:OLD SAYBROOK
Mailing Address - State:CT
Mailing Address - Zip Code:06475-1548
Mailing Address - Country:US
Mailing Address - Phone:860-388-1654
Mailing Address - Fax:860-388-6748
Practice Address - Street 1:142 BOSTON POST RD
Practice Address - Street 2:
Practice Address - City:OLD SAYBROOK
Practice Address - State:CT
Practice Address - Zip Code:06475-1548
Practice Address - Country:US
Practice Address - Phone:860-388-1654
Practice Address - Fax:860-388-6748
Is Sole Proprietor?:No
Enumeration Date:2018-12-31
Last Update Date:2021-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT002215111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor