Provider Demographics
NPI:1285404061
Name:CONROY, PAUL JOHN SR
Entity type:Individual
Prefix:MR
First Name:PAUL
Middle Name:JOHN
Last Name:CONROY
Suffix:SR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 E MAIN ST APT 153
Mailing Address - Street 2:
Mailing Address - City:SOMERSET
Mailing Address - State:PA
Mailing Address - Zip Code:15501-2165
Mailing Address - Country:US
Mailing Address - Phone:814-521-8837
Mailing Address - Fax:
Practice Address - Street 1:9083 SR 41
Practice Address - Street 2:
Practice Address - City:BAINBRIDGE
Practice Address - State:OH
Practice Address - Zip Code:45612
Practice Address - Country:US
Practice Address - Phone:814-521-8837
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-03
Last Update Date:2024-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
No172A00000XOther Service ProvidersDriver
No372500000XNursing Service Related ProvidersChore Provider