Individual
MR. DAVID E. KONNICK JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
L.P.N.
Contact information
Practice address
320 BLUEPOINT RD., BLUEPOINT, NY 11715
(631) 357-1050
Mailing address
33 ROBIN RD, ROCKY POINT, NY 11778-8941
(631) 849-5115
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
280386
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02668197
—
NY
Enumeration date
02/02/2007
Last updated
07/09/2007
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