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General NPI Number Information
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NPI Number | 1891731824
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Entity Type | Individual
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Provider Name | MARYANA KONYK N.P.
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Gender | Female
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Dates
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Enumeration Date | 06/20/2006
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Last Update Date | 07/05/2023
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Provider Practice Location Address
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Address Line | 2300 W JEFFERSON RD STE 400
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City | PITTSFORD
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State | NY
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Zip | 14534-1090
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Country | US
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Telephone | 585-427-9950
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Fax | 585-424-2788
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Provider Business Mailing Address
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Address Line | ROCHESTER INTERNAL MEDICINE ASSOCIATES 2300 WEST JEFFERSON RD, SUITE 400
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City | PITTSFORD
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State | NY
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Zip | 14534-1090
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Country | US
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Telephone | 585-427-9950
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Fax | 585-244-2788
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 333724
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License Number State | NY
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