Individual
DOREEN KONIK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
11 OLD PARK LN, NEW MILFORD, CT 06776-2507
(860) 355-1149
(860) 355-5957
Mailing address
11 OLD PARK LN, NEW MILFORD, CT 06776-2507
(860) 355-1149
(860) 355-5957
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
42886
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001428863
—
CT
01
—
010042886CT01
ANTHEM BC/BS
CT
01
—
042886
CONNECTICARE
CT
01
—
2V7088
ACS/HEALTHNET
CT
01
—
4300290
AETNA/USHC
CT
01
—
P3597904
OXFORD
CT
Enumeration date
02/02/2006
Last updated
04/19/2024
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