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NPI 1356338792

NPI 1356338792 : DON KOENIGSBERG DO : PHILADELPHIA, PA

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General NPI Number Information
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    NPI Number           |    1356338792
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    Entity Type          |    Individual 
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    Provider Name        |    DON KOENIGSBERG DO
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    09/30/2005
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    Last Update Date     |    07/21/2022
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Provider Practice Location Address
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    Address Line         |    2222 S BROAD ST 
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    City                 |    PHILADELPHIA
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    State                |    PA
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    Zip                  |    19145-3948
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    Country              |    US
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    Telephone            |    215-467-7212
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    Fax                  |    215-467-7216
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Provider Business Mailing Address
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    Address Line         |    2222 S BROAD ST 
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    City                 |    PHILADELPHIA
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    State                |    PA
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    Zip                  |    19145-3948
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    Country              |    US
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    Telephone            |    215-467-7212
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    Fax                  |    215-467-7216
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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        |    207LP2900X
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    Taxonomy Name        |    Pain Medicine (Anesthesiology) Physician
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    License Number       |    OS004701L
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    License Number State |    PA
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Taxonomy #2
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    Taxonomy Code        |    207L00000X
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    Taxonomy Name        |    Anesthesiology Physician
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    License Number       |    OS004701L
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    License Number State |    PA
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