Provider Demographics
NPI:1003587619
Name:KOND MEDICAL LLC
Entity Type:Organization
Organization Name:KOND MEDICAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:NERINA
Authorized Official - Middle Name:J
Authorized Official - Last Name:MOULTRIEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:315-717-2126
Mailing Address - Street 1:1 HOPPER ST
Mailing Address - Street 2:
Mailing Address - City:UTICA
Mailing Address - State:NY
Mailing Address - Zip Code:13501-3508
Mailing Address - Country:US
Mailing Address - Phone:315-864-8587
Mailing Address - Fax:
Practice Address - Street 1:1 HOPPER ST
Practice Address - Street 2:
Practice Address - City:UTICA
Practice Address - State:NY
Practice Address - Zip Code:13501-3508
Practice Address - Country:US
Practice Address - Phone:315-864-8587
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-23
Last Update Date:2021-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251G00000XAgenciesHospice Care, Community Based
No251J00000XAgenciesNursing Care