Individual
AMADO E CONANAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
P.T.
Contact information
Practice address
5718 WOODSIDE AVE, 2ND FLOOR, WOODSIDE, NY 11377-3444
(718) 205-0030
(718) 205-6136
Mailing address
5718 WOODSIDE AVE, 2ND FLOOR, WOODSIDE, NY 11377-3444
(718) 205-0030
(718) 205-6136
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
022161
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02527282
—
NY
Enumeration date
02/06/2007
Last updated
01/05/2011
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