Provider Demographics
NPI:1376169425
Name:CONLEY OPTOMETRY SERVICES, PC
Entity type:Organization
Organization Name:CONLEY OPTOMETRY SERVICES, PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:
Authorized Official - Last Name:CONLEY
Authorized Official - Suffix:
Authorized Official - Credentials:OD, MJ
Authorized Official - Phone:516-587-9332
Mailing Address - Street 1:2177 MEROKEE DR
Mailing Address - Street 2:
Mailing Address - City:MERRICK
Mailing Address - State:NY
Mailing Address - Zip Code:11566-3604
Mailing Address - Country:US
Mailing Address - Phone:516-587-9332
Mailing Address - Fax:
Practice Address - Street 1:214 WALL ST STE 100
Practice Address - Street 2:
Practice Address - City:HUNTINGTON
Practice Address - State:NY
Practice Address - Zip Code:11743-7804
Practice Address - Country:US
Practice Address - Phone:516-587-9332
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-24
Last Update Date:2020-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty