Healthcare Provider Details

I. General information

NPI: 1528007101
Provider Name (Legal Business Name): JOSEPH M CONEY M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/06/2006
Last Update Date: 03/25/2020
Certification Date: 03/25/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3401 ENTERPRISE PKWY
BEACHWOOD OH
44122-7341
US

IV. Provider business mailing address

3401 ENTERPRISE PKWY
BEACHWOOD OH
44122-7341
US

V. Phone/Fax

Practice location:
  • Phone: 216-831-5700
  • Fax: 216-831-1959
Mailing address:
  • Phone: 216-831-5700
  • Fax: 216-831-1959

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number35.088072
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code207WX0107X
TaxonomyRetina Specialist (Ophthalmology) Physician
License Number35-088072
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: