Individual
DR. VLAD KONONCHUK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
75-59 263RD ST, GLEN OAKS, NY 11004
(718) 470-4834
Mailing address
75-59 263RD STREET, GLEN OAKS, NY 11004
(718) 470-4834
Taxonomy
Speciality
Code
Description
License number
State
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
246523
NY
Other
Enumeration date
05/21/2007
Last updated
07/08/2010
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