Provider Demographics
NPI:1578661252
Name:CONCEPCION, AHMED PAUL (ATC)
Entity Type:Individual
Prefix:MR
First Name:AHMED
Middle Name:PAUL
Last Name:CONCEPCION
Suffix:
Gender:M
Credentials:ATC
Other - Prefix:MR
Other - First Name:PAUL
Other - Middle Name:
Other - Last Name:CONCEPCION
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:6648 NORMANDY DRIVE
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:CA
Mailing Address - Zip Code:94560
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2345 MAIN ST
Practice Address - Street 2:
Practice Address - City:GLASTONBURY
Practice Address - State:CT
Practice Address - Zip Code:06033
Practice Address - Country:US
Practice Address - Phone:800-998-0880
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer