MEDICARE: DR. JOSEPH E CONROY PH.D.

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	103G00000X	Clinical Neuropsychologist	3356	NJ

General Provider Information

NPI Number	:	1952325730
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOSEPH E CONROY PH.D.

Provider Business Mailing Address
First Line	:	1859 N PARIS AVE
Second Line	:	SUITE 212
City	:	PORT ROYAL
State	:	SC
Zip	:	29935-2029
Country	:	US
Telephone Number	:	732-859-0213
Fax Number	:	800-853-3788

Provider Business Practice Location Address
First Line	:	1859 N PARIS AVE
Second Line	:	SUITE 212
City	:	PORT ROYAL
State	:	SC
Zip	:	29935-2029
Country	:	US
Telephone Number	:	732-859-0213
Fax Number	:	800-853-3788

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

Provider Enumeration Date	:	07/26/2006
Last Update Date	:	08/18/2016

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