Provider Demographics
NPI:1144566621
Name:KONIKOFF, JOANNA ERICA (MS)
Entity Type:Individual
Prefix:MRS
First Name:JOANNA
Middle Name:ERICA
Last Name:KONIKOFF
Suffix:
Gender:F
Credentials:MS
Other - Prefix:MISS
Other - First Name:JOANNA
Other - Middle Name:ERICA
Other - Last Name:BEST
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS
Mailing Address - Street 1:51 SAINT JOHNS PARKSIDE ST
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14210-2515
Mailing Address - Country:US
Mailing Address - Phone:716-861-7566
Mailing Address - Fax:
Practice Address - Street 1:51 SAINT JOHNS PARKSIDE ST
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14210-2515
Practice Address - Country:US
Practice Address - Phone:716-861-7566
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-01-02
Last Update Date:2013-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY591026121174400000X
OHOH3098370174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist