Provider Demographics
NPI:1073518668
Name:SALADA-CONROY, JEANNE M (PNP)
Entity Type:Individual
Prefix:MS
First Name:JEANNE
Middle Name:M
Last Name:SALADA-CONROY
Suffix:
Gender:F
Credentials:PNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:85 BRYANT WOODS S
Mailing Address - Street 2:
Mailing Address - City:AMHERST
Mailing Address - State:NY
Mailing Address - Zip Code:14228-3604
Mailing Address - Country:US
Mailing Address - Phone:716-689-3333
Mailing Address - Fax:716-689-9866
Practice Address - Street 1:85 BRYANT WOODS S
Practice Address - Street 2:
Practice Address - City:AMHERST
Practice Address - State:NY
Practice Address - Zip Code:14228-3604
Practice Address - Country:US
Practice Address - Phone:716-689-3333
Practice Address - Fax:716-689-9866
Is Sole Proprietor?:No
Enumeration Date:2005-06-20
Last Update Date:2011-01-07
Deactivation Date:2005-06-21
Deactivation Code:
Reactivation Date:2005-07-01
Provider Licenses
StateLicense IDTaxonomies
NYF4000602363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY000560592001OtherHEALTH INTEGRATED
NY1506808OtherINDEPENDENT HEALTH
NY000560592001OtherBC/BS OF WNY
NY00025511301OtherUNIVERA HEALTHCARE
NY11124255OtherCAQH
NY000560592001OtherHEALTH INTEGRATED
NY000560592001OtherBC/BS OF WNY