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General NPI Number Information
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NPI Number | 1164043535
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Entity Type | Individual
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Provider Name | CONNOR CONTI CAA
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Gender | Male
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Dates
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Enumeration Date | 04/27/2020
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Last Update Date | 06/02/2020
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Provider Practice Location Address
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Address Line | 110 IRVING ST NW
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City | WASHINGTON
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State | DC
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Zip | 20010-3017
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Country | US
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Telephone | 202-877-7000
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Fax |
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Provider Business Mailing Address
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Address Line | 60 L ST NE APT 1103
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City | WASHINGTON
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State | DC
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Zip | 20002-2073
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Country | US
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Telephone | 570-242-1467
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 367H00000X
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Taxonomy Name | Anesthesiologist Assistant
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License Number | AA000136
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License Number State | DC
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