Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2080P0201X | Pediatric Allergist | 19351 | TN |
NPI | 1598721680 |
---|---|
Provider Name | Dr. Mary Ellen Conley |
First Address | New York, NY 10065-6307 |
Second Address | New York, NY 10065-6307 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/04/2006 |
Last Update Date | 16/10/2014 |