Individual
MR. ANDREW CHRISTOPHER KONOPACKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
456 PROSPECT AVE, WEST ORANGE, NJ 07052-4112
(973) 731-6767
(973) 731-9881
Mailing address
328 W SAINT GEORGES AVE, LINDEN, NJ 07036-5638
(908) 925-7519
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
25MP00407700
NJ
Other
Enumeration date
09/29/2016
Last updated
09/29/2016
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