Individual
ERIC STEVEN KOENIGSDORF
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
1300 ROANOKE AVE, RIVERHEAD, NY 11901-2031
(631) 548-6000
Mailing address
43 SENIX AVE, CENTER MORICHES, NY 11934-2902
(631) 766-8931
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
021648
NY
Other
Enumeration date
11/30/2017
Last updated
11/30/2017
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