Healthcare Provider Details

I. General information

NPI: 1598629495
Provider Name (Legal Business Name): CONLEY ROBERT KRIEGLER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/15/2025
Last Update Date: 12/15/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

75 FRANCIS STREET
BOSTON MA
02115
US

IV. Provider business mailing address

11707 84 AVE NW
EDMONTON ALBERTA
T6G OW2
CA

V. Phone/Fax

Practice location:
  • Phone: 617-525-7391
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: