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Individual

KRISTINE KONYK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
1425 PORTLAND AVE UNIT G1, ROCHESTER, NY 14621-3011
(585) 922-3880
Mailing address
100 KINGS HWY S, ROCHESTER, NY 14617-5504

Taxonomy

Speciality
Code
Description
License number
State
163WE0003X
Emergency Registered Nurse
771057
NY
363L00000X
Nurse Practitioner
Primary
352773
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
771057
RN LICENSE NUMBER
NY
Enumeration date
04/17/2023
Last updated
01/31/2024
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