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General NPI Number Information
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NPI Number | 1336307271
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Entity Type | Organization
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Legal Business Name | COMPREHENSIVE NEUROPSYCHOLOGY LLC
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Dates
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Enumeration Date | 05/28/2008
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Last Update Date | 12/20/2016
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Provider Practice Location Address
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Address Line | 1859 N PARIS AVE
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City | PORT ROYAL
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State | SC
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Zip | 29935-2029
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Country | US
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Telephone | 843-271-3737
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Fax | 800-853-3788
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Provider Business Mailing Address
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Address Line | 1859 N PARIS AVE
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City | PORT ROYAL
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State | SC
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Zip | 29935-2029
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Country | US
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Telephone | 843-271-3737
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Fax | 800-853-3788
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Authorized Official
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Title or Position | DIRECTOR
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Name | DR. JOSEPH E CONROY
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Credential | PHD
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Telephone | 843-271-3737
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103G00000X
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Taxonomy Name | Clinical Neuropsychologist
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License Number | SI00335600
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License Number State | NJ
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