Individual
JESSICA MARIE KOENIG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
52 HARDING ST, EAST NORTHPORT, NY 11731-1111
(917) 603-7871
Mailing address
52 HARDING ST, EAST NORTHPORT, NY 11731-1111
(917) 603-7871
Taxonomy
Speciality
Code
Description
License number
State
246XS1301X
Sonography Specialist/Technologist Cardiovascular
163424
NY
2471S1302X
Sonography Radiologic Technologist
163424
NY
2471V0105X
Vascular Sonography Radiologic Technologist
Primary
163424
NY
Other
Enumeration date
06/10/2014
Last updated
06/10/2014
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