Provider Demographics
NPI:1083981328
Name:CONLIN, DARYLE SCOTT
Entity Type:Individual
Prefix:MR
First Name:DARYLE
Middle Name:SCOTT
Last Name:CONLIN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:96 MINAVILLE ST
Mailing Address - Street 2:
Mailing Address - City:AMSTERDAM
Mailing Address - State:NY
Mailing Address - Zip Code:12010-5608
Mailing Address - Country:US
Mailing Address - Phone:518-210-5440
Mailing Address - Fax:
Practice Address - Street 1:2440 RIVERFRONT CTR
Practice Address - Street 2:
Practice Address - City:AMSTERDAM
Practice Address - State:NY
Practice Address - Zip Code:12010-4612
Practice Address - Country:US
Practice Address - Phone:518-210-5440
Practice Address - Fax:518-843-3217
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-30
Last Update Date:2022-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY14000011872332S00000X, 237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist
No332S00000XSuppliersHearing Aid Equipment
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY14000011872OtherNY STATE