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General NPI Number Information
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NPI Number | 1720085061
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Entity Type | Individual
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Provider Name | DMITRY KONSKY D.O.
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Gender | Male
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Dates
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Enumeration Date | 07/01/2005
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Last Update Date | 03/01/2023
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Provider Practice Location Address
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Address Line | 1 HEALTHY WAY
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City | OCEANSIDE
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State | NY
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Zip | 11572-1551
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Country | US
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Telephone | 516-632-3666
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Fax |
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Provider Business Mailing Address
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Address Line | 31 SARAH DR
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City | DIX HILLS
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State | NY
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Zip | 11746-6321
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Country | US
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Telephone | 469-371-8466
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Fax |
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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 | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | 225308
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 225308
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License Number State | NY
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