MEDICARE: FILOMENA R KOENIGSBERG NP

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	363LA2200X	Adult Health Nurse Practitioner	R149099	MD
2	363L00000X	Nurse Practitioner	A0307116	MD
3	163W00000X	Registered Nurse	R149099	MD

General Provider Information

NPI Number	:	1912042946
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	FILOMENA R KOENIGSBERG NP

Provider Business Mailing Address
First Line	:	6201 GREENLEIGH AVE
Second Line	:
City	:	MIDDLE RIVER
State	:	MD
Zip	:	21220-2004
Country	:	US
Telephone Number	:	410-933-6423
Fax Number	:	410-500-4266

Provider Business Practice Location Address
First Line	:	1800 ORLEANS STREET
Second Line	:
City	:	BALTIMORE
State	:	MD
Zip	:	21264-4435
Country	:	US
Telephone Number	:	410-955-5000
Fax Number	:

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

Provider Enumeration Date	:	02/20/2007
Last Update Date	:	09/24/2024

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