MEDICARE: DR. GERALD A CONIGLIO M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist	117158	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1902801186
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GERALD A CONIGLIO M.D.

Provider Business Mailing Address
First Line	:	37 MURRAY ST
Second Line	:
City	:	MOUNT MORRIS
State	:	NY
Zip	:	14510-1335
Country	:	US
Telephone Number	:	585-658-3667
Fax Number	:

Provider Business Practice Location Address
First Line	:	115 MAIN ST
Second Line	:
City	:	MOUNT MORRIS
State	:	NY
Zip	:	14510-1217
Country	:	US
Telephone Number	:	585-658-3120
Fax Number	:	585-658-4393

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/15/2005
Last Update Date	:	03/20/2017

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