Provider Demographics
NPI:1619274065
Name:CONWAY, EILEEN P (LPN)
Entity Type:Individual
Prefix:MRS
First Name:EILEEN
Middle Name:P
Last Name:CONWAY
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:141 PARK AVE
Mailing Address - Street 2:
Mailing Address - City:NEW CITY
Mailing Address - State:NY
Mailing Address - Zip Code:10956-5026
Mailing Address - Country:US
Mailing Address - Phone:845-634-5427
Mailing Address - Fax:
Practice Address - Street 1:141 PARK AVE
Practice Address - Street 2:
Practice Address - City:NEW CITY
Practice Address - State:NY
Practice Address - Zip Code:10956-5026
Practice Address - Country:US
Practice Address - Phone:845-634-5427
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-22
Last Update Date:2011-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY243713164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse