MEDICARE: STONEBRIDGE FAMILY MEDICINE PLLC

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	207Q00000X	Family Medicine Physician

General Provider Information

NPI Number	:	1013853373
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	STONEBRIDGE FAMILY MEDICINE PLLC

Provider Business Mailing Address
First Line	:	PO BOX 188
Second Line	:
City	:	BABYLON
State	:	NY
Zip	:	11702-0188
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	60 QUEENS ST
Second Line	:
City	:	SYOSSET
State	:	NY
Zip	:	11791-3058
Country	:	US
Telephone Number	:	516-973-1916
Fax Number	:

Authorized Official
Title or Position	:	OWNER/PHYSICIAN
Name	:	DR. TONY CONIGLIARO
Credential	:	DO
Telephone Number	:	516-973-1916

Provider Enumeration Date	:	04/28/2026
Last Update Date	:	04/28/2026

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