MEDICARE: ANNA KATHERINE KOENIGSDORF FNP

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
1	363LF0000X	Family Nurse Practitioner	348213	NY
2	363LF0000X	Family Nurse Practitioner	26NJ15092700	NJ

General Provider Information

NPI Number	:	1316613946
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANNA KATHERINE KOENIGSDORF FNP

Provider Business Mailing Address
First Line	:	1810 ASTORIA PARK S APT 3R
Second Line	:
City	:	ASTORIA
State	:	NY
Zip	:	11102-3444
Country	:	US
Telephone Number	:	631-617-8401
Fax Number	:

Provider Business Practice Location Address
First Line	:	100 E 77TH ST
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10075-1850
Country	:	US
Telephone Number	:	212-434-2000
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/23/2021
Last Update Date	:	02/10/2026

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