Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 111NN0400X | Neurology | X005592-1 | NY |
N | 111NS0005X | Chiropractic Sports Physician | X005592-1 | NY |
NPI | 1447398235 |
---|---|
Provider Name | Dr. Steven John Coniglio |
First Address | Ny, NY 10011 |
Second Address | New York, NY 10011-6101 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/02/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
C05592-3B | WORKERS COMP (01) | NY |