Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207V00000X | Obstetrician & Gynecologist | 021260 | NY |
NPI | 1003326232 |
---|---|
Provider Name | Theresa Mary Conway |
First Address | Williston Park, NY 11596-1133 |
Second Address | Manhasset, NY 11030-3816 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/10/2017 |
Last Update Date | 02/10/2017 |