Most Relevant Information
Provider Data
| NPI Number: | 1003253964 |
| Provider Name: | DI FAN CONEYBEARE M.D. |
| Entity Type: | Individual |
| Taxonomy Code: | 390200000X |
| Specialty: | Student in an Organized Health Care Education/Training Program |
| License Number: |
Most Important Dates
| Enumeration Date: | 05/31/2013 |
| Last Updated: | 08/17/2023 |
Provider Practice Location
622 W 168TH ST
NEW YORK
NY
100323720
Practice Location Phone/Fax
| Phone: | 7608082557 |
| Fax: |
Provider Mailing Location
622 W 168TH ST # VC260
NEW YORK
NY
100323720
Provider Mailing Phone/Fax
| Phone: | 7608082557 |
| Fax: |