Provider Demographics
NPI:1891092342
Name:CONROY, ELIZABETH K (MS, LAC)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:K
Last Name:CONROY
Suffix:
Gender:F
Credentials:MS, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:777 S 3RD ST APT 1103
Mailing Address - Street 2:
Mailing Address - City:HARRISON
Mailing Address - State:NJ
Mailing Address - Zip Code:07029-2167
Mailing Address - Country:US
Mailing Address - Phone:347-416-1396
Mailing Address - Fax:
Practice Address - Street 1:777 S 3RD ST APT 1103
Practice Address - Street 2:
Practice Address - City:HARRISON
Practice Address - State:NJ
Practice Address - Zip Code:07029-2167
Practice Address - Country:US
Practice Address - Phone:347-416-1396
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-02-18
Last Update Date:2023-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY25 004413171100000X
NJ25MZ00106600171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist