Provider Demographics
NPI:1154779270
Name:CONWAY, CATHERINE E (DO)
Entity type:Individual
Prefix:
First Name:CATHERINE
Middle Name:E
Last Name:CONWAY
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:571 SAINT JOSEPHS BLVD FL 2
Mailing Address - Street 2:
Mailing Address - City:ELMIRA
Mailing Address - State:NY
Mailing Address - Zip Code:14901-3230
Mailing Address - Country:US
Mailing Address - Phone:607-271-2050
Mailing Address - Fax:607-873-1244
Practice Address - Street 1:104 S PORTER ST
Practice Address - Street 2:
Practice Address - City:WATKINS GLEN
Practice Address - State:NY
Practice Address - Zip Code:14891-1622
Practice Address - Country:US
Practice Address - Phone:607-535-7873
Practice Address - Fax:607-535-7469
Is Sole Proprietor?:No
Enumeration Date:2016-05-31
Last Update Date:2022-10-17
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY318840207Q00000X
PAOS0169869207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY05814640Medicaid