MEDICARE: MICHAEL CONLON, INC

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	261QP2000X	Physical Therapy Clinic/Center	018121-1	NY

General Provider Information

NPI Number	:	1457438988
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MICHAEL CONLON, INC

Provider Business Mailing Address
First Line	:	330 E 59TH ST
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10022-1537
Country	:	US
Telephone Number	:	212-486-8573
Fax Number	:	212-486-8498

Provider Business Practice Location Address
First Line	:	330 E 59TH ST
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10022-1537
Country	:	US
Telephone Number	:	212-486-8573
Fax Number	:	212-486-8498

Authorized Official
Title or Position	:	P.T.
Name	:	MR. MICHAEL J CONLON
Credential	:
Telephone Number	:	212-486-8573

Provider Enumeration Date	:	11/01/2006
Last Update Date	:	08/22/2020

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Directions to “MICHAEL CONLON, INC ” Practice Location

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