Provider Demographics
NPI:1134136492
Name:CONROY, BRENDAN (MD)
Entity type:Individual
Prefix:DR
First Name:BRENDAN
Middle Name:
Last Name:CONROY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2100 MACK BLVD FL 4
Mailing Address - Street 2:
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18103-5622
Mailing Address - Country:US
Mailing Address - Phone:484-884-4550
Mailing Address - Fax:
Practice Address - Street 1:2775 SCHOENERSVILLE RD
Practice Address - Street 2:
Practice Address - City:BETHLEHEM
Practice Address - State:PA
Practice Address - Zip Code:18017-7307
Practice Address - Country:US
Practice Address - Phone:610-402-1757
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-01
Last Update Date:2025-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA310000208100000X
DCMD18859208100000X
PAMD487280C208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
4384446OtherAETNA NON HMO
4384525OtherAENA NON-HMO
489391005OtherCIGNA
5460-0102OtherBS NCA
814510OtherAETNA HMO
325793OtherMAMSI
1052462OtherAETNA HMO
MD161381200Medicaid
250007826OtherMEDICARE RAILROAD
5460-0037OtherBS NCA
DCA0018859OtherBC NCA
603962-01OtherBS OF MD
DC024038600Medicaid
112523OtherKAISER
252153OtherKAISER
494972OtherNCPPO