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General NPI Number Information
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NPI Number | 1053481259
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Entity Type | Individual
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Provider Name | PAUL KOENIG MD
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Gender | Male
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Dates
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Enumeration Date | 11/08/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | MMC - DEPT. OF PEDIATRICS 3444 KOSSUTH AVENUE
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City | BRONX
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State | NY
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Zip | 10467
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Country | US
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Telephone | 718-920-5872
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Fax |
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Provider Business Mailing Address
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Address Line | 126 SURREY LN
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City | TENAFLY
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State | NJ
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Zip | 07670-2517
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Country | US
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Telephone | 718-920-5872
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Fax | 718-652-5707
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 141980
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License Number State | NY
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