Provider Demographics
NPI:1265564140
Name:G & I KONDRAY MD INC
Entity type:Organization
Organization Name:G & I KONDRAY MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:GREGORY
Authorized Official - Middle Name:F
Authorized Official - Last Name:KONDRAY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:216-581-0470
Mailing Address - Street 1:12000 MCCRACKEN RD #101
Mailing Address - Street 2:
Mailing Address - City:GARFIELD HTS
Mailing Address - State:OH
Mailing Address - Zip Code:44125
Mailing Address - Country:US
Mailing Address - Phone:216-581-0470
Mailing Address - Fax:216-581-0474
Practice Address - Street 1:12000 MCCRACKEN RD
Practice Address - Street 2:# 101
Practice Address - City:GARFIELD HTS
Practice Address - State:OH
Practice Address - Zip Code:44125
Practice Address - Country:US
Practice Address - Phone:216-581-0470
Practice Address - Fax:216-581-0474
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-09
Last Update Date:2014-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH039156208800000X
OH046323207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Multi-Specialty
No208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Multi-Specialty