Provider Demographics
NPI:1295915106
Name:CONROY, THOMAS NORMAN (DC)
Entity type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:NORMAN
Last Name:CONROY
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21 PARK PL
Mailing Address - Street 2:
Mailing Address - City:WILLISTON PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11596-1138
Mailing Address - Country:US
Mailing Address - Phone:516-877-0113
Mailing Address - Fax:516-927-0261
Practice Address - Street 1:15031 UNION TPKE
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11367-3927
Practice Address - Country:US
Practice Address - Phone:718-544-1444
Practice Address - Fax:718-969-1595
Is Sole Proprietor?:No
Enumeration Date:2007-11-07
Last Update Date:2009-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX007152111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY05331Q NYOtherMEDICARE