Most Relevant Information
Provider Data
| NPI Number: | 1003404328 |
| Provider Name: | NATALIE KONOPKA |
| Entity Type: | Individual |
| Taxonomy Code: | 163W00000X |
| Specialty: | Registered Nurse |
| License Number: | 802141 |
Most Important Dates
| Enumeration Date: | 01/03/2021 |
| Last Updated: | 01/03/2021 |
Provider Practice Location
25 EVERGREEN AVE
PORT JEFFERSON STATION
NY
117761046
Practice Location Phone/Fax
| Phone: | 6313757675 |
| Fax: |
Provider Mailing Location
25 EVERGREEN AVE
PORT JEFFERSON STATION
NY
117761046
Provider Mailing Phone/Fax
| Phone: | 6313757675 |
| Fax: |