Provider Demographics
NPI:1295011104
Name:CONNER, JAMES RYAN (MD, PHD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:RYAN
Last Name:CONNER
Suffix:
Gender:M
Credentials:MD, PHD
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Mailing Address - Street 1:170 BROOKLINE AVE
Mailing Address - Street 2:APARTMENT 618
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02215-3937
Mailing Address - Country:US
Mailing Address - Phone:857-998-0505
Mailing Address - Fax:
Practice Address - Street 1:75 FRANCIS ST
Practice Address - Street 2:BRIGHAM AND WOMEN'S HOSPITAL, DEPARTMENT OF PATHOLOGY
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02115-6110
Practice Address - Country:US
Practice Address - Phone:857-998-0505
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-10-25
Last Update Date:2011-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MABB5204071-JC224207ZP0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0101XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology