Provider Demographics
NPI:1326206731
Name:CONLON, MARY KATHLEEN (NP)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:KATHLEEN
Last Name:CONLON
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:160 E 53RD ST
Mailing Address - Street 2:7TH FLOOR PRE-SURGICAL TESTING
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10022-5243
Mailing Address - Country:US
Mailing Address - Phone:212-610-0488
Mailing Address - Fax:212-588-1363
Practice Address - Street 1:160 E 53RD ST
Practice Address - Street 2:7TH FLOOR PRE-SURGICAL TESTING
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10022-5243
Practice Address - Country:US
Practice Address - Phone:212-610-0488
Practice Address - Fax:212-588-1363
Is Sole Proprietor?:No
Enumeration Date:2008-06-02
Last Update Date:2008-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF430143-1363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care