Provider Demographics
NPI:1821116161
Name:CONROY, ADRIENNE (PSYD)
Entity Type:Individual
Prefix:
First Name:ADRIENNE
Middle Name:
Last Name:CONROY
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:48 S NEW YORK RD
Mailing Address - Street 2:UNIT B6
Mailing Address - City:GALLOWAY
Mailing Address - State:NJ
Mailing Address - Zip Code:08205-9680
Mailing Address - Country:US
Mailing Address - Phone:609-404-1156
Mailing Address - Fax:
Practice Address - Street 1:48 S NEW YORK RD
Practice Address - Street 2:UNIT B6
Practice Address - City:GALLOWAY
Practice Address - State:NJ
Practice Address - Zip Code:08205-9680
Practice Address - Country:US
Practice Address - Phone:609-404-1156
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJSI00384700103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical