Individual provider Active NPI

Mary Elizabeth Conway, REGISTERED NURSE

  • Gerontology Registered Nurse
  • Rocky Point, NY
National Provider Identifier
1639434285
Registry record updated Jul 10, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Registered NurseTaxonomy code 163WG0600X
License
4945011 Issued in NY
Practice address
77 Hallock LN
Rocky Point, NY 11778-8906
Phone
(631) 209-9120
NPI assigned
Jul 10, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 10, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Registered Nurse 163WG0600X 4945011 NY Primary

Addresses

Primary practice location

77 Hallock LN
Rocky Point, NY 11778-8906

Mailing address

77 Hallock LN
Rocky Point, NY 11778-8906
Phone (631) 209-9120

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
4945011NYMDGerontology Registered Nurse

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1341878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1341878400000",
    "number": "1639434285",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "77 HALLOCK LN",
            "city": "ROCKY POINT",
            "state": "NY",
            "postal_code": "117788906",
            "telephone_number": "631-209-9120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "77 HALLOCK LN",
            "city": "ROCKY POINT",
            "state": "NY",
            "postal_code": "117788906",
            "telephone_number": "631-209-9120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONWAY",
        "first_name": "MARY",
        "middle_name": "ELIZABETH",
        "credential": "REGISTERED NURSE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-07-10",
        "last_updated": "2012-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WG0600X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Gerontology",
            "state": "NY",
            "license": "4945011",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rocky Point, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.