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NPI Code Detail

MEDICARE: DR. ZENOVIA KONDOLIOS M.D.

MEDICARE: DR. ZENOVIA KONDOLIOS M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208000000XPediatrics Physician35-07-8591-KOH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1720050610
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ZENOVIA KONDOLIOS M.D.
Provider Business Mailing Address
First Line : 321 NILES CORTLAND RD NE
Second Line :
City : WARREN
State : OH
Zip : 44484-1974
Country : US
Telephone Number : 330-609-5588
Fax Number : 330-609-5740
Provider Business Practice Location Address
First Line : 321 NILES CORTLAND RD NE
Second Line :
City : WARREN
State : OH
Zip : 44484-1974
Country : US
Telephone Number : 330-609-5588
Fax Number : 330-609-5740
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/03/2006
Last Update Date : 07/08/2007

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