Provider Demographics
NPI:1275534380
Name:KONDRAY, ILDIKO T (MD)
Entity Type:Individual
Prefix:
First Name:ILDIKO
Middle Name:T
Last Name:KONDRAY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:88 CENTER RD
Mailing Address - Street 2:
Mailing Address - City:BEDFORD
Mailing Address - State:OH
Mailing Address - Zip Code:44146-2700
Mailing Address - Country:US
Mailing Address - Phone:440-735-4260
Mailing Address - Fax:440-735-4255
Practice Address - Street 1:88 CENTER RD STE 300
Practice Address - Street 2:
Practice Address - City:BEDFORD
Practice Address - State:OH
Practice Address - Zip Code:44146-2711
Practice Address - Country:US
Practice Address - Phone:440-735-4260
Practice Address - Fax:440-735-4255
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-10
Last Update Date:2021-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH046323207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0463154Medicaid
0800140OtherUNITED HEALTH CARE
OH000000130876OtherANTHEM BCBS
A80130Medicare UPIN
OH0463154Medicaid