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NPI Code Detail

MEDICARE: THERESA CONROY

MEDICARE: THERESA CONROY
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
1363LF0000XFamily Nurse Practitioner003909CT

General Provider Information

NPI Number : 1255584587
Entity Type Code : Individual
Provider Name (Legal Business Name) : THERESA CONROY
Provider Business Mailing Address
First Line : 24 PERSHING DR # 36
Second Line :
City : ANSONIA
State : CT
Zip : 06401-2214
Country : US
Telephone Number : 612-225-1534
Fax Number :
Provider Business Practice Location Address
First Line : 24 PERSHING DR # 36
Second Line :
City : ANSONIA
State : CT
Zip : 06401-2214
Country : US
Telephone Number : 612-225-1534
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/30/2008
Last Update Date : 01/18/2017

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Directions to “ THERESA CONROY ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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