Provider Demographics
NPI:1033313101
Name:CONROY, KATHLEEN N (MD)
Entity Type:Individual
Prefix:DR
First Name:KATHLEEN
Middle Name:N
Last Name:CONROY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:95 LONGWOOD AVE
Mailing Address - Street 2:APT 5
Mailing Address - City:BROOKLINE
Mailing Address - State:MA
Mailing Address - Zip Code:02446-6659
Mailing Address - Country:US
Mailing Address - Phone:617-650-0731
Mailing Address - Fax:
Practice Address - Street 1:850 HARRISON AVE # ACC5
Practice Address - Street 2:ONE BOSTON MEDICAL CENTER PLACE
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02118-4001
Practice Address - Country:US
Practice Address - Phone:617-414-5946
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA231810208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics