Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0808X | Nurse Practitioner - Psychiatric/Mental Health | F401206-1 | NY |
NPI | 1003045592 |
---|---|
Provider Name | Ms. Meredith Hooper Conry |
First Address | New York, NY 10001-6227 |
Second Address | New York, NY 10001-6227 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/07/2009 |
Last Update Date | 06/07/2009 |