Individual
JUSTIN CONWAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1200 ROUTE 300, NEWBURGH, NY 12550-5003
(845) 703-6999
(845) 703-6297
Mailing address
155 CRYSTAL RUN RD, MIDDLETOWN, NY 10941
(845) 703-6999
(845) 703-6297
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
284699
NY
207QS0010X
Sports Medicine (Family Medicine) Physician
Primary
284699
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04495098
—
NY
Enumeration date
04/23/2012
Last updated
08/06/2020
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