MEDICARE: KAREN CONN

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	174400000X	Specialist		NY

General Provider Information

NPI Number	:	1740664135
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KAREN CONN

Provider Business Mailing Address
First Line	:	320 W PARK ST
Second Line	:
City	:	ALBION
State	:	NY
Zip	:	14411-1347
Country	:	US
Telephone Number	:	585-590-0801
Fax Number	:

Provider Business Practice Location Address
First Line	:	320 W PARK ST
Second Line	:
City	:	ALBION
State	:	NY
Zip	:	14411-1347
Country	:	US
Telephone Number	:	585-590-0801
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/15/2015
Last Update Date	:	07/15/2015

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Directions to “ KAREN CONN ” Practice Location

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