| Doctor Name: | MR. COLIN CONISKI |
| NPI Number: | 1073942611 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PA-C |
| License Number: | 016952 |
| Business Practice Address: | 1724 Burrstone Rd New Hartford, NY - 134131002 |
| Business Phone Number: | 3156244740 |
| Business Fax Number: | 3156244760 |
| Mailing Address: | 1724 Burrstone Rd, NEW HARTFORD |
| State: | NY |
| Postal Code: | 134131002 |
| Phone Number: | 3156244740 |
| Fax Number: | 3156244760 |
| NPI Enumeration Date: | 11/04/2013 |
| NPI Last Update Date: | 11/04/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AS0400X |
| License Number: | 016952 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Surgical |
| Taxonomy Definition: | |