Healthcare Provider Details
I. General information
NPI: 1578475117
Provider Name (Legal Business Name): ALEXANDER CONEZIO, D.O. PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/18/2026
Last Update Date: 09/18/2026
Certification Date: 09/18/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1921 W HOSPITAL DR
TUCSON AZ
85704-7806
US
IV. Provider business mailing address
4539 N 22ND ST STE N
PHOENIX AZ
85016-4639
US
V. Phone/Fax
- Phone: 520-742-2800
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208100000X |
| Taxonomy | Physical Medicine & Rehabilitation Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
ALEXANDER
HAN MIN
CONEZIO
Title or Position: PHYSIATRIST
Credential: DO
Phone: 585-402-0811