Provider Demographics
NPI:1265521298
Name:CONATY, SUSAN (PA)
Entity type:Individual
Prefix:MS
First Name:SUSAN
Middle Name:
Last Name:CONATY
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:260 MIDDLE COUNTRY RD
Mailing Address - Street 2:SUITE 208
Mailing Address - City:SMITHTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:11787-2982
Mailing Address - Country:US
Mailing Address - Phone:631-863-3223
Mailing Address - Fax:631-863-3334
Practice Address - Street 1:260 MIDDLE COUNTRY ROAD
Practice Address - Street 2:SUITE 208
Practice Address - City:SMITHTOWN
Practice Address - State:NY
Practice Address - Zip Code:11787
Practice Address - Country:US
Practice Address - Phone:631-863-3223
Practice Address - Fax:631-863-3334
Is Sole Proprietor?:No
Enumeration Date:2006-10-11
Last Update Date:2011-06-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY0016601363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYP81895Medicare UPIN