Individual
OLGA KONYKHOV
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
87 GRANDVIEW AVE, WATERBURY, CT 06708-2514
(203) 574-2020
(203) 596-2230
Mailing address
87 GRANDVIEW AVE, WATERBURY, CT 06708-2514
(203) 574-2020
(203) 596-2230
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
46287
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1245375880
—
CT
Enumeration date
02/21/2007
Last updated
01/24/2017
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