Individual
DR. DONNA R KONICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
1045 JAMES ST, SYRACUSE, NY 13203-2730
(315) 413-7692
(315) 422-3068
Mailing address
1045 JAMES ST, SYRACUSE, NY 13203-2730
(315) 413-7692
(315) 422-3068
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
T004912-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00168680
BCBS
NY
01
—
2566952
UHC
—
01
—
7431754
AETNA
NY
01
—
796636
MVP
—
01
—
928789001
HEALTH NOW
NY
Enumeration date
03/11/2006
Last updated
10/13/2021
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