Provider Demographics
NPI:1669484911
Name:KONTOR, ANNAMARIA (MD)
Entity Type:Individual
Prefix:DR
First Name:ANNAMARIA
Middle Name:
Last Name:KONTOR
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 1:90 VALEWOOD RUN
Mailing Address - Street 2:
Mailing Address - City:PENFIELD
Mailing Address - State:NY
Mailing Address - Zip Code:14526-2809
Mailing Address - Country:US
Mailing Address - Phone:585-388-7897
Mailing Address - Fax:585-388-7897
Practice Address - Street 1:2067 FAIRPORT NINE MILE POINT RD
Practice Address - Street 2:SUITE 110
Practice Address - City:PENFIELD
Practice Address - State:NY
Practice Address - Zip Code:14526-1752
Practice Address - Country:US
Practice Address - Phone:585-922-0460
Practice Address - Fax:585-922-0470
Is Sole Proprietor?:No
Enumeration Date:2006-08-13
Last Update Date:2022-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY227285208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02377888Medicaid
NYDD6506Medicare ID - Type Unspecified
NY02377888Medicaid