Provider Demographics
NPI:1467525535
Name:CONRY, JOHN MICHAEL (PHARMD, BCPS)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:MICHAEL
Last Name:CONRY
Suffix:
Gender:M
Credentials:PHARMD, BCPS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1011 GRACE TER
Mailing Address - Street 2:
Mailing Address - City:TEANECK
Mailing Address - State:NJ
Mailing Address - Zip Code:07666-2622
Mailing Address - Country:US
Mailing Address - Phone:718-990-2486
Mailing Address - Fax:718-990-1986
Practice Address - Street 1:8000 UTOPIA PKWY
Practice Address - Street 2:ST. ALBERT HALL, ROOM 114
Practice Address - City:JAMAICA
Practice Address - State:NY
Practice Address - Zip Code:11439-0001
Practice Address - Country:US
Practice Address - Phone:718-990-2486
Practice Address - Fax:718-990-1986
Is Sole Proprietor?:No
Enumeration Date:2006-11-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0445191835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy