Provider Demographics
NPI:1932844008
Name:KIJANKA, KRISTOPHER CONNER (DO)
Entity Type:Individual
Prefix:DR
First Name:KRISTOPHER
Middle Name:CONNER
Last Name:KIJANKA
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7132 PENDALE CIR
Mailing Address - Street 2:
Mailing Address - City:NORTH TONAWANDA
Mailing Address - State:NY
Mailing Address - Zip Code:14120-9713
Mailing Address - Country:US
Mailing Address - Phone:716-863-7617
Mailing Address - Fax:
Practice Address - Street 1:DETROIT MEDICAL CENTER GME OFFICE
Practice Address - Street 2:4201 SAINT ANTOINE ST, UHC-9C
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48201-2153
Practice Address - Country:US
Practice Address - Phone:313-745-3000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-03
Last Update Date:2022-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program