MEDICARE: ASHLEY CONNORS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2085R0202X	Diagnostic Radiology Physician	584879	NY

General Provider Information

NPI Number	:	1003437807
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ASHLEY CONNORS

Provider Business Mailing Address
First Line	:	346 N KENTUCKY AVE
Second Line	:
City	:	NORTH MASSAPEQUA
State	:	NY
Zip	:	11758-1119
Country	:	US
Telephone Number	:	845-417-8823
Fax Number	:

Provider Business Practice Location Address
First Line	:	150 SUNRISE HWY STE 201
Second Line	:
City	:	LINDENHURST
State	:	NY
Zip	:	11757-2539
Country	:	US
Telephone Number	:	631-444-5544
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/03/2020
Last Update Date	:	05/03/2020

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Directions to “ ASHLEY CONNORS ” Practice Location

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