Provider Demographics
NPI:1851358121
Name:CONAHAN, JOSEPH B JR (MD)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:B
Last Name:CONAHAN
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:300 PLAZA COURT
Mailing Address - Street 2:SUITE A
Mailing Address - City:EAST STROUDSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:18301-8260
Mailing Address - Country:US
Mailing Address - Phone:570-421-8842
Mailing Address - Fax:570-476-5842
Practice Address - Street 1:300 PLAZA COURT
Practice Address - Street 2:SUITE A
Practice Address - City:EAST STROUDSBURG
Practice Address - State:PA
Practice Address - Zip Code:18301-8260
Practice Address - Country:US
Practice Address - Phone:570-421-8842
Practice Address - Fax:570-476-5842
Is Sole Proprietor?:No
Enumeration Date:2006-04-28
Last Update Date:2010-06-04
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Provider Licenses
StateLicense IDTaxonomies
PAMD011738E207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0007557040003Medicaid
PA0007557040003Medicaid
C0019242Medicare ID - Type Unspecified