MEDICARE: NII O KONEY M.D.

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	2085R0204X	Vascular & Interventional Radiology Physician	MD187654	OR
2	2085R0202X	Diagnostic Radiology Physician	MD60845644	WA
3	2085R0204X	Vascular & Interventional Radiology Physician	287747	NY
4	2085R0202X	Diagnostic Radiology Physician	287747	NY
5	2085N0904X	Nuclear Radiology Physician	14213083-1235	UT
6	207U00000X	Nuclear Medicine Physician	287747	NY

General Provider Information

NPI Number	:	1649536301
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NII O KONEY M.D.

Provider Business Mailing Address
First Line	:	3181 SW SAM JACKSON PARK RD
Second Line	:
City	:	PORTLAND
State	:	OR
Zip	:	97239-3011
Country	:	US
Telephone Number	:	503-494-7660
Fax Number	:	503-494-4258

Provider Business Practice Location Address
First Line	:	1 BROOKDALE PLZ
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11212-3198
Country	:	US
Telephone Number	:	718-240-5000
Fax Number	:

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

Provider Enumeration Date	:	04/06/2012
Last Update Date	:	02/10/2026

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Directions to “ NII O KONEY M.D.” Practice Location

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