| Mark A Mcconn Md Pllc | |
|
4117 Medical Center Dr Fayetteville NY 13066-6600 | |
| (315) 329-4975 | |
| Not Available |
| Full Name | Mark A Mcconn Md Pllc |
|---|---|
| Speciality | Family Medicine |
| Location | 4117 Medical Center Dr, Fayetteville, New York |
| Authorized Official Name and Position | Mark A Mcconn (DIRECTOR) |
| Authorized Official Contact | 3153294975 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mark A Mcconn Md Pllc 4117 Medical Center Dr Fayetteville NY 13066-6600 Ph: (315) 329-4975 | Mark A Mcconn Md Pllc 4117 Medical Center Dr Fayetteville NY 13066-6600 Ph: (315) 329-4975 |
| NPI Number | 1235474438 |
|---|---|
| Provider Enumeration Date | 11/29/2012 |
| Last Update Date | 11/29/2012 |
| Medicare PECOS PAC ID | 4385889831 |
|---|---|
| Medicare Enrollment ID | O20130404000031 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235474438 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Michael T Schiano |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1245246933 PECOS PAC ID: 3173520178 Enrollment ID: I20061106000305 |
| Provider Name | Susan L Merola-mcconn |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1346201068 PECOS PAC ID: 0446394639 Enrollment ID: I20100226000060 |
| Provider Name | Mark A Mcconn |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1952361354 PECOS PAC ID: 8527154574 Enrollment ID: I20100226000194 |
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