Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208100000X | Physical Medicine & Rehabilitation Doctor | C1-0009379 | DE |
N | 208100000X | Physical Medicine & Rehabilitation Doctor | MD430071 | PA |
N | 2081P2900X | Pain Medicine | C1-0009379 | DE |
Y | 2081P2900X | Pain Medicine | MD430071 | PA |
NPI | 1033275045 |
---|---|
Provider Name | Jeffrey Conly |
First Address | Lancaster, PA 17601-4132 |
Second Address | Lancaster, PA 17601 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/12/2006 |
Last Update Date | 12/02/2021 |