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General NPI Number Information
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NPI Number | 1821323155
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Entity Type | Organization
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Legal Business Name | ORANGETOWN PODIATRY PC
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Dates
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Enumeration Date | 10/05/2009
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Last Update Date | 03/11/2011
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Provider Practice Location Address
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Address Line | 100 DUTCH HILL RD SUITE 270
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City | ORANGEBURG
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State | NY
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Zip | 10962-2197
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Country | US
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Telephone | 845-365-3100
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Fax | 845-365-3253
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Provider Business Mailing Address
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Address Line | 100 DUTCH HILL RD SUITE 270
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City | ORANGEBURG
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State | NY
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Zip | 10962-2197
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Country | US
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Telephone | 845-365-3100
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Fax | 845-365-3253
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Authorized Official
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Title or Position | OWNER
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Name | DR. ROBERT MICHAEL CONENELLO
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Credential | DPM
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Telephone | 845-365-3100
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number |
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License Number State |
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