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DR. EDWARD LEO CONNOLLY PH.D.

Clinical Neuropsychologist

Oakland, New Jersey

Provider NPI: 1093872103

Provider Information:
DR. EDWARD LEO CONNOLLY PH.D.
Gender: M
Sole Proprietor


Practice Location:
9 POST RD SUITE D-1 OAKLAND, NJ 07436 US
Tel: 201-405-1991  Fax: 201-581-0376

Business Mailing Address:
9 POST RD SUITE D-1 OAKLAND, NJ 07436 US
Tel: 201-405-1991  Fax: 201-581-0376

Entity Type: Individual

Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
X103G00000XBehavioral Health & Social Service Providers
Clinical Neuropsychologist
NJ35SI00381600
X103TC0700XBehavioral Health & Social Service Providers
Psychologist
NJ35SI00381600

Other Provider Identifiers:

IssuerNumberStateType
CAQH10764753NJ01
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin







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