Provider Demographics
NPI:1336171057
Name:CONIGLIO, KRISTEN (DC)
Entity Type:Individual
Prefix:DR
First Name:KRISTEN
Middle Name:
Last Name:CONIGLIO
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2154 NEWBRIDGE RD
Mailing Address - Street 2:
Mailing Address - City:BELLMORE
Mailing Address - State:NY
Mailing Address - Zip Code:11710-2239
Mailing Address - Country:US
Mailing Address - Phone:516-221-0225
Mailing Address - Fax:516-785-6210
Practice Address - Street 1:2154 NEWBRIDGE RD
Practice Address - Street 2:
Practice Address - City:BELLMORE
Practice Address - State:NY
Practice Address - Zip Code:11710-2239
Practice Address - Country:US
Practice Address - Phone:516-221-0225
Practice Address - Fax:516-785-6210
Is Sole Proprietor?:No
Enumeration Date:2006-07-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX011147111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYV08438Medicare UPIN
NYX05A81Medicare ID - Type Unspecified