Provider Demographics
NPI:1447490602
Name:CONABOY, ARIANE M (DO)
Entity type:Individual
Prefix:DR
First Name:ARIANE
Middle Name:M
Last Name:CONABOY
Suffix:
Gender:F
Credentials:DO
Other - Prefix:DR
Other - First Name:ARIANE
Other - Middle Name:M
Other - Last Name:PALMASANI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:1032 N WASHINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:SCRANTON
Mailing Address - State:PA
Mailing Address - Zip Code:18509-2918
Mailing Address - Country:US
Mailing Address - Phone:570-558-8660
Mailing Address - Fax:570-558-6147
Practice Address - Street 1:1032 N WASHINGTON AVE
Practice Address - Street 2:
Practice Address - City:SCRANTON
Practice Address - State:PA
Practice Address - Zip Code:18509-2918
Practice Address - Country:US
Practice Address - Phone:570-558-8660
Practice Address - Fax:570-558-6147
Is Sole Proprietor?:No
Enumeration Date:2009-03-02
Last Update Date:2014-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS015680207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA102613792Medicaid
PA102613792Medicaid