Individual provider · Type 1 NPI

John Eldridge Connolly, MD

Student in an Organized Health Care Education/Training Program · Philadelphia, PA

NPI number 1104516145 Active

Practice location

3400 Civic Center Blvd
Philadelphia, PA 19104-5127

Call (215) 662-3990 Map

Specialties and licenses

TaxonomyCodeLicense
Student in an Organized Health Care Education/Training Program Primary 390200000XNone listed

Student in an Organized Health Care Education/Training Program: An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

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About NPI 1104516145

John Eldridge Connolly, MD's National Provider Identifier is 1104516145, issued on May 12, 2023. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in Philadelphia, PA. The record was last updated on Aug 10, 2026.