Provider Demographics
NPI:1487727855
Name:CONNELL, LEONORA M (RN DC)
Entity type:Individual
Prefix:
First Name:LEONORA
Middle Name:M
Last Name:CONNELL
Suffix:
Gender:F
Credentials:RN DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6384 MILL STREET
Mailing Address - Street 2:
Mailing Address - City:RHINEBECK
Mailing Address - State:NY
Mailing Address - Zip Code:12572
Mailing Address - Country:US
Mailing Address - Phone:845-876-5556
Mailing Address - Fax:875-876-5559
Practice Address - Street 1:6384 MILL STREET
Practice Address - Street 2:
Practice Address - City:RHINEBECK
Practice Address - State:NY
Practice Address - Zip Code:12572
Practice Address - Country:US
Practice Address - Phone:845-876-5556
Practice Address - Fax:875-876-5559
Is Sole Proprietor?:No
Enumeration Date:2006-11-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX0051181111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
X53081Medicare ID - Type Unspecified