Individual
AMANDA LYNN KONIECZNY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
6 WELLNESS WAY STE 109, LATHAM, NY 12110-2156
(518) 785-5882
(518) 783-8510
Mailing address
6 WELLNESS WAY STE 201, LATHAM, NY 12110-2156
(518) 782-3700
(518) 782-3799
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
347791
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
06623954
—
NY
Enumeration date
07/15/2021
Last updated
02/15/2024
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