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General NPI Number Information
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NPI Number | 1982397055
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Entity Type | Individual
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Provider Name | MR. JEFFREY CONROY
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Gender | Male
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Dates
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Enumeration Date | 06/02/2023
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Last Update Date | 09/03/2024
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Provider Practice Location Address
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Address Line | 35TH MEDICAL GROUP UNIT 5024
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City | APO
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State | AP
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Zip | 96319-5024
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Country | US
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Telephone | 315-226-3230
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Fax |
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Provider Business Mailing Address
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Address Line | 35TH MEDICAL GROUP UNIT 5024
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City | APO
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State | AP
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Zip | 96319-5024
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Country | US
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Telephone |
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | 149.027463
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License Number State | IL
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