Timothy Conlon, RPH
Individual provider Active NPI Pharmacist · Brockport, NY
NPI 1003131293 · NPPES record last updated Mar 31, 2010
Key facts
- NPI
- 1003131293
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 039030 (NY)
- Practice address
- 6265 Brockport Spencerport Rd
Brockport, NY 14420-2605 - Phone
- (585) 637-6500
- NPI assigned
- Mar 31, 2010
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 039030 | NY | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 039030 | NY | Yes |
Addresses
Primary practice location
6265 Brockport Spencerport Rd
Brockport, NY 14420-2605
Mailing address
12 Warner Park
Le Roy, NY 14482-1410
Phone (585) 768-4839
Other providers in Brockport, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 31, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.