Doctor Name: | MS. TARA ANN CONWAY |
NPI Number: | 1770672594 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | 027233-1 |
Business Practice Address: | 175 Sunrise Hwy West Islip, NY - 117952011 |
Business Phone Number: | 6313211100 |
Business Fax Number: | 6313211761 |
Mailing Address: | 500 Portion Rd, Suite 5 LAKE RONKONKOMA |
State: | NY |
Postal Code: | 117794587 |
Phone Number: | 6315882100 |
Fax Number: | 6315882299 |
NPI Enumeration Date: | 10/12/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225100000X |
License Number: | 027233-1 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Physical Therapist |
Taxonomy Specialization: | |
Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |