1851356810 NPI number — DR. JEANNIE KAO KOENIG M.D.

Table of content: CECELIA THOMAS DPT (NPI 1912428020)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1851356810 NPI number — DR. JEANNIE KAO KOENIG M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
KOENIG
Provider First Name:
JEANNIE
Provider Middle Name:
KAO
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1851356810
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/20/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 563
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
GETZVILLE
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
14068-0563
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
716-870-5340
Provider Business Mailing Address Fax Number:
716-639-5961

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
565 ABBOTT RD
Provider Second Line Business Practice Location Address:
REHABILITATION DEPARTMENT
Provider Business Practice Location Address City Name:
BUFFALO
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
14220-2039
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
716-821-4450
Provider Business Practice Location Address Fax Number:
716-828-2765
Provider Enumeration Date:
04/20/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 208100000X , with the licence number:  2213431 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 02273398 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 3011286 . This is a "INDEPENDENT HEALTH" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 000526519004 . This is a "BLUE CROSS" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 00025687702 . This is a "UNIVERA" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: P00333863 . This is a "MEDICARE RR" identifier . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com