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Michael Kevin Connolly

Emergency Medicine

Allopathic & Osteopathic Physicians

100 Madison Ave, Morristown, NJ 07960-6136

PECOS Enrollment

This provider is enrolled in PECOS as MICHAEL CONNOLLY.

Based on the most recent information from CMS, provider Michael Kevin Connolly is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records today at 4:18 PM.

Profile Details

Provider ID
1689089005
Provider Type
Individual
Full Name
Connolly, Michael Kevin
Title
Dr.
Credential
M.D.

Gender
Male
Sole Proprietor
Yes
Enumeration Date
6/24/2014
Last Updated
2/12/2021

Contact Information

Practice Location

100 Madison Ave, Morristown, NJ 07960-6136

(973) 971-7926

Unlisted Fax

Mailing Location

53 Boulder Run Rd, Paterson, NJ 07501-3374

(973) 224-3529

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 207P00000X Primary	Description Emergency Medicine Allopathic & Osteopathic Physicians	License 25MA10550700 New Jersey

Michael Kevin Connolly

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

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