Provider Demographics
NPI:1891058343
Name:CONVEY, SUSAN SKELLY
Entity Type:Individual
Prefix:MRS
First Name:SUSAN
Middle Name:SKELLY
Last Name:CONVEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:295 REIST ST
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14221-5341
Mailing Address - Country:US
Mailing Address - Phone:716-631-8162
Mailing Address - Fax:
Practice Address - Street 1:295 REIST ST
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14221-5341
Practice Address - Country:US
Practice Address - Phone:716-631-8162
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-20
Last Update Date:2012-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist