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NPI Code Detail

MEDICARE: DEBORAH CONROY

MEDICARE: DEBORAH 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
1225200000XPhysical Therapy Assistant134OH

General Provider Information

NPI Number : 1346638715
Entity Type Code : Individual
Provider Name (Legal Business Name) : DEBORAH CONROY
Provider Business Mailing Address
First Line : 10017 BROADVIEW RD
Second Line :
City : BROADVIEW HTS
State : OH
Zip : 44147-3216
Country : US
Telephone Number : 440-655-4364
Fax Number :
Provider Business Practice Location Address
First Line : 9001 W 130TH ST
Second Line :
City : NORTH ROYALTON
State : OH
Zip : 44133-1011
Country : US
Telephone Number : 440-237-3104
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/07/2015
Last Update Date : 01/07/2015

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