Provider Demographics
NPI:1881793701
Name:CONN, KAREN LYNNE (RPH)
Entity type:Individual
Prefix:MS
First Name:KAREN
Middle Name:LYNNE
Last Name:CONN
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3351 LAURIE BROOK DR
Mailing Address - Street 2:
Mailing Address - City:BINGHAMTON
Mailing Address - State:NY
Mailing Address - Zip Code:13903-3153
Mailing Address - Country:US
Mailing Address - Phone:607-724-1446
Mailing Address - Fax:
Practice Address - Street 1:1188 VESTAL AVE
Practice Address - Street 2:
Practice Address - City:BINGHAMTON
Practice Address - State:NY
Practice Address - Zip Code:13903-1612
Practice Address - Country:US
Practice Address - Phone:607-723-7584
Practice Address - Fax:607-773-0936
Is Sole Proprietor?:No
Enumeration Date:2006-09-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY041339183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY041339OtherPHARMACIST LICENSE NUMBER