Basic Information
| Provider Information | |||||||||
| NPI: | 1073507927 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | CONROY | ||||||||
| FirstName: | MAUREEN | ||||||||
| MiddleName: | B | ||||||||
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| Credential: | DO | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2580 HAYMAKER RD STE 201 | ||||||||
| Address2: | |||||||||
| City: | MONROEVILLE | ||||||||
| State: | PA | ||||||||
| PostalCode: | 151463500 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4128567500 | ||||||||
| FaxNumber: | 4128566079 | ||||||||
| Practice Location | |||||||||
| Address1: | 2580 HAYMAKER RD STE 201 | ||||||||
| Address2: | |||||||||
| City: | MONROEVILLE | ||||||||
| State: | PA | ||||||||
| PostalCode: | 151463500 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4128567500 | ||||||||
| FaxNumber: | 4128566079 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/07/2005 | ||||||||
| LastUpdateDate: | 08/30/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207V00000X | OS009527L | PA | Y | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology |
ID Information
| ID | Type | State | Issuer | Description | 001825868 | 05 | PA | MEDICAID |