Provider Demographics
NPI:1417034430
Name:KONDRACKI, JANET (RN, CDE)
Entity Type:Individual
Prefix:
First Name:JANET
Middle Name:
Last Name:KONDRACKI
Suffix:
Gender:F
Credentials:RN, CDE
Other - Prefix:
Other - First Name:JANET
Other - Middle Name:
Other - Last Name:MOREY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:711 TROY SCHENECTADY RD
Mailing Address - Street 2:SUITE 203
Mailing Address - City:LATHAM
Mailing Address - State:NY
Mailing Address - Zip Code:12110-2442
Mailing Address - Country:US
Mailing Address - Phone:518-782-3823
Mailing Address - Fax:518-782-3799
Practice Address - Street 1:713 TROY SCHENECTADY RD
Practice Address - Street 2:SUITE 218
Practice Address - City:LATHAM
Practice Address - State:NY
Practice Address - Zip Code:12110-2490
Practice Address - Country:US
Practice Address - Phone:518-783-3839
Practice Address - Fax:518-782-3761
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY435812163WD0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WD0400XNursing Service ProvidersRegistered NurseDiabetes Educator