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NPI Code Detail

MEDICARE: CONOR KIELY

MEDICARE:   CONOR  KIELY
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
1390200000XStudent in an Organized Health Care Education/Training ProgramRS2026-0068NM

General Provider Information

NPI Number : 1104767326
Entity Type Code : Individual
Provider Name (Legal Business Name) : CONOR KIELY
Provider Business Mailing Address
First Line : MSC10 5550
Second Line :
City : ALBUQUERQUE
State : NM
Zip : 87131-0001
Country : US
Telephone Number : 505-272-3160
Fax Number : 505-272-9427
Provider Business Practice Location Address
First Line : MSC10 5550
Second Line :
City : ALBUQUERQUE
State : NM
Zip : 87131-0001
Country : US
Telephone Number : 505-272-3160
Fax Number : 505-272-9427
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/02/2026
Last Update Date : 05/18/2026

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Directions to “ CONOR KIELY ” Practice Location

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