Provider Demographics
NPI:1083611982
Name:CONLEY, JAMES G (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:G
Last Name:CONLEY
Suffix:
Gender:M
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:PO BOX 534274
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15253-4274
Mailing Address - Country:US
Mailing Address - Phone:716-859-2987
Mailing Address - Fax:716-859-2988
Practice Address - Street 1:100 HIGH ST
Practice Address - Street 2:6TH FLOOR
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14203-1126
Practice Address - Country:US
Practice Address - Phone:716-859-2987
Practice Address - Fax:716-859-2988
Is Sole Proprietor?:No
Enumeration Date:2005-07-07
Last Update Date:2015-03-03
Deactivation Date:2006-03-21
Deactivation Code:
Reactivation Date:2006-03-28
Provider Licenses
StateLicense IDTaxonomies
NY129057-1207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00713259Medicaid
NY080127Medicare PIN
NY00713259Medicaid
NY080127Medicare PIN