Provider Demographics
NPI:1528120235
Name:HARRY JOHN CONIARIS MD PC
Entity type:Organization
Organization Name:HARRY JOHN CONIARIS MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:HARRY
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:CONIARIS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:732-888-3688
Mailing Address - Street 1:723 N BEERS ST
Mailing Address - Street 2:SUITE1C
Mailing Address - City:HOLMDEL
Mailing Address - State:NJ
Mailing Address - Zip Code:07733-1517
Mailing Address - Country:US
Mailing Address - Phone:732-888-3688
Mailing Address - Fax:732-888-3633
Practice Address - Street 1:723 N BEERS ST
Practice Address - Street 2:SUITE 1C
Practice Address - City:HOLMDEL
Practice Address - State:NJ
Practice Address - Zip Code:07733-1517
Practice Address - Country:US
Practice Address - Phone:732-888-3688
Practice Address - Fax:732-888-3633
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-16
Last Update Date:2016-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY171667207W00000X
NJMA50416207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1181460002Medicare NSC
NY1181460001Medicare NSC