Provider Demographics
NPI:1821135534
Name:KONOPKA, ANNA MARIA (MD)
Entity Type:Individual
Prefix:
First Name:ANNA
Middle Name:MARIA
Last Name:KONOPKA
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 1:92 BUNKER RD
Mailing Address - Street 2:
Mailing Address - City:NEW LONDON
Mailing Address - State:NH
Mailing Address - Zip Code:03257
Mailing Address - Country:US
Mailing Address - Phone:603-526-6029
Mailing Address - Fax:603-526-6029
Practice Address - Street 1:92 BUNKER RD
Practice Address - Street 2:
Practice Address - City:NEW LONDON
Practice Address - State:NH
Practice Address - Zip Code:03257
Practice Address - Country:US
Practice Address - Phone:603-526-6029
Practice Address - Fax:603-526-6029
Is Sole Proprietor?:No
Enumeration Date:2007-01-31
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH42452080A0000X
NY0999132080A0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30002935Medicaid
NH30002935Medicaid
D47631Medicare UPIN
AC0759576OtherDEA