Individual
DEBRA KOENIG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
19 BRADHURST AVE # 3090N, HAWTHORNE, NY 10532-2140
(914) 493-2181
Mailing address
19 BRADHURST AVE # 3090N, HAWTHORNE, NY 10532-2140
(914) 493-2181
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
—
—
363AS0400X
Surgical Physician Assistant
026684
NY
Other
Enumeration date
05/26/2021
Last updated
04/21/2022
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