Provider Demographics
NPI:1811693773
Name:KONING, HEIDI S (PT)
Entity type:Individual
Prefix:MRS
First Name:HEIDI
Middle Name:S
Last Name:KONING
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 DRISCOLL DR
Mailing Address - Street 2:
Mailing Address - City:UNCASVILLE
Mailing Address - State:CT
Mailing Address - Zip Code:06382-1808
Mailing Address - Country:US
Mailing Address - Phone:860-608-7094
Mailing Address - Fax:
Practice Address - Street 1:251 TURN OF RIVER RD
Practice Address - Street 2:
Practice Address - City:STAMFORD
Practice Address - State:CT
Practice Address - Zip Code:06905-1320
Practice Address - Country:US
Practice Address - Phone:475-619-3027
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-02
Last Update Date:2023-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT006209225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist