Provider Demographics
NPI:1093528150
Name:MACDONALD, CONNOR ANTHONY
Entity type:Individual
Prefix:
First Name:CONNOR
Middle Name:ANTHONY
Last Name:MACDONALD
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 1:6 PINEWOOD RD
Mailing Address - Street 2:
Mailing Address - City:AMESBURY
Mailing Address - State:MA
Mailing Address - Zip Code:01913-1973
Mailing Address - Country:US
Mailing Address - Phone:781-426-6046
Mailing Address - Fax:
Practice Address - Street 1:6 PINEWOOD RD
Practice Address - Street 2:
Practice Address - City:AMESBURY
Practice Address - State:MA
Practice Address - Zip Code:01913-1973
Practice Address - Country:US
Practice Address - Phone:781-426-6046
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-30
Last Update Date:2025-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer