Provider Demographics
NPI:1891731824
Name:KONYK, MARYANA (NP)
Entity Type:Individual
Prefix:
First Name:MARYANA
Middle Name:
Last Name:KONYK
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:ROCHESTER INTERNAL MEDICINE ASSOCIATES
Mailing Address - Street 2:2300 WEST JEFFERSON RD, SUITE 400
Mailing Address - City:PITTSFORD
Mailing Address - State:NY
Mailing Address - Zip Code:14534-1090
Mailing Address - Country:US
Mailing Address - Phone:585-427-9950
Mailing Address - Fax:585-244-2788
Practice Address - Street 1:2300 W JEFFERSON RD STE 400
Practice Address - Street 2:
Practice Address - City:PITTSFORD
Practice Address - State:NY
Practice Address - Zip Code:14534-1090
Practice Address - Country:US
Practice Address - Phone:585-427-9950
Practice Address - Fax:585-424-2788
Is Sole Proprietor?:No
Enumeration Date:2006-06-20
Last Update Date:2023-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY333724363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYP019333724OtherBLUE CHOICE
NY7941529OtherAETNA
NYNP0574OtherPREFERRED CARE
NYP019333724OtherBLUE CHOICE