Provider Demographics
NPI:1144466012
Name:CONWAY, CARYN E (MS CCC-SLP)
Entity type:Individual
Prefix:MS
First Name:CARYN
Middle Name:E
Last Name:CONWAY
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4353 STATE ROUTE 49
Mailing Address - Street 2:
Mailing Address - City:FULTON
Mailing Address - State:NY
Mailing Address - Zip Code:13069-4426
Mailing Address - Country:US
Mailing Address - Phone:315-481-3223
Mailing Address - Fax:
Practice Address - Street 1:4353 STATE ROUTE 49
Practice Address - Street 2:
Practice Address - City:FULTON
Practice Address - State:NY
Practice Address - Zip Code:13069-4426
Practice Address - Country:US
Practice Address - Phone:315-481-3223
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-26
Last Update Date:2008-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY12103062235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist