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General NPI Number Information
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NPI Number | 1104282110
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Entity Type | Organization
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Legal Business Name | THOMAS E. CONWAY, LCSW, P.C.
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Dates
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Enumeration Date | 01/06/2016
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Last Update Date | 02/08/2016
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Provider Practice Location Address
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Address Line | 1050 W JERICHO TPKE
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City | SMITHTOWN
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State | NY
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Zip | 11787-3242
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Country | US
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Telephone | 631-864-2778
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Fax | 631-864-2779
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Provider Business Mailing Address
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Address Line | 1050 W JERICHO TPKE
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City | SMITHTOWN
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State | NY
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Zip | 11787-3242
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Country | US
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Telephone | 631-864-2778
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Fax | 631-864-2779
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Authorized Official
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Title or Position | PRESIDENT
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Name | THOMAS E. CONWAY
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Credential | LCSW
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Telephone | 631-864-2778
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | R026000-1
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License Number State | NY
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