Provider Demographics
NPI:1205042694
Name:VONKORFF, PETER (PHD)
Entity Type:Individual
Prefix:MR
First Name:PETER
Middle Name:
Last Name:VONKORFF
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 231
Mailing Address - Street 2:
Mailing Address - City:BEMUS POINT
Mailing Address - State:NY
Mailing Address - Zip Code:14712-0231
Mailing Address - Country:US
Mailing Address - Phone:716-386-1019
Mailing Address - Fax:716-386-1020
Practice Address - Street 1:120 E 2ND ST
Practice Address - Street 2:THIRD FLOOR
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16507-1537
Practice Address - Country:US
Practice Address - Phone:716-753-0077
Practice Address - Fax:716-720-5952
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-15
Last Update Date:2022-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY009060-1103T00000X
PAPS0093766103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist