Individual
CARLY ANN KONIECZNY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
9500 EUCLID AVE, CLEVELAND, OH 44195-0001
(216) 444-0793
Mailing address
13141 SPERRY RD, CHESTERLAND, OH 44026-3210
(440) 479-6509
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
50.005033RX
OH
Other
Enumeration date
07/25/2017
Last updated
03/17/2018
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