Provider Demographics
NPI:1780733550
Name:KONOPSKI, TANYA (OTR-L)
Entity type:Individual
Prefix:MRS
First Name:TANYA
Middle Name:
Last Name:KONOPSKI
Suffix:
Gender:F
Credentials:OTR-L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5896 RAILROAD AVENUE
Mailing Address - Street 2:
Mailing Address - City:KANONA
Mailing Address - State:NY
Mailing Address - Zip Code:14856-0055
Mailing Address - Country:US
Mailing Address - Phone:607-331-4455
Mailing Address - Fax:
Practice Address - Street 1:5896 RAILROAD AVENUE
Practice Address - Street 2:
Practice Address - City:KANONA
Practice Address - State:NY
Practice Address - Zip Code:14856-0055
Practice Address - Country:US
Practice Address - Phone:607-331-4455
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-09
Last Update Date:2010-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY013611-1225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist