Provider Demographics
NPI:1558457580
Name:CONNOR, JANE M (PHD)
Entity Type:Individual
Prefix:DR
First Name:JANE
Middle Name:M
Last Name:CONNOR
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:317 MANCHESTER RD
Mailing Address - Street 2:
Mailing Address - City:VESTAL
Mailing Address - State:NY
Mailing Address - Zip Code:13850-3604
Mailing Address - Country:US
Mailing Address - Phone:607-797-2179
Mailing Address - Fax:607-797-7787
Practice Address - Street 1:317 MANCHESTER RD
Practice Address - Street 2:
Practice Address - City:VESTAL
Practice Address - State:NY
Practice Address - Zip Code:13850-3604
Practice Address - Country:US
Practice Address - Phone:607-797-2179
Practice Address - Fax:607-797-7787
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0062371103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist