Individual
DR. DOUGLAS S KONDZIOLKA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
530 1ST AVE, SUITE 8R, NEW YORK, NY 10016-6402
(212) 263-2950
Mailing address
530 1ST AVE, SUITE 8R, NEW YORK, NY 10016-6402
(212) 263-2950
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
MD042521L
PA
207T00000X
Neurological Surgery Physician
Primary
267044
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001269761
—
PA
Enumeration date
02/14/2006
Last updated
03/09/2021
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