Organization
B KONNIKOW PHYSICIAN PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BORIS A KONNIKOW M.D. (PRESIDENT)
(718) 263-3355
Entity
Organization
Contact information
Practice address
11020 71ST RD, #104, FOREST HILLS, NY 11375-4945
(718) 263-3355
(718) 263-3373
Mailing address
7636 113TH ST, 5B, FOREST HILLS, NY 11375-6513
(718) 263-3355
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
204106
NY
Other
Enumeration date
04/11/2008
Last updated
04/14/2008
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