Provider Demographics
NPI:1740023910
Name:NAKONECZNA, MONIKA ANITA
Entity type:Individual
Prefix:
First Name:MONIKA
Middle Name:ANITA
Last Name:NAKONECZNA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17 VILLAGE GRN APT D
Mailing Address - Street 2:
Mailing Address - City:RHINEBECK
Mailing Address - State:NY
Mailing Address - Zip Code:12572-1328
Mailing Address - Country:US
Mailing Address - Phone:347-429-1580
Mailing Address - Fax:
Practice Address - Street 1:14379 US ROUTE 9W
Practice Address - Street 2:
Practice Address - City:RAVENA
Practice Address - State:NY
Practice Address - Zip Code:12143-3103
Practice Address - Country:US
Practice Address - Phone:518-756-3124
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-17
Last Update Date:2024-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist