Provider Demographics
NPI:1194180083
Name:CONROY, SEAN ELIZABETH (PA-C)
Entity Type:Individual
Prefix:MISS
First Name:SEAN
Middle Name:ELIZABETH
Last Name:CONROY
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1402 LINDBERGH AVE
Mailing Address - Street 2:
Mailing Address - City:ROSLYN
Mailing Address - State:PA
Mailing Address - Zip Code:19001-2315
Mailing Address - Country:US
Mailing Address - Phone:215-906-8444
Mailing Address - Fax:
Practice Address - Street 1:1101 PAOLI PIKE
Practice Address - Street 2:
Practice Address - City:WEST CHESTER
Practice Address - State:PA
Practice Address - Zip Code:19380-4642
Practice Address - Country:US
Practice Address - Phone:610-918-2500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-12-21
Last Update Date:2015-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA058037363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical