Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208800000X | Urologist | 35039156 | OH |
NPI | 1053420570 |
---|---|
Provider Name | Gregory F Kondray |
First Address | Belfast, ME 04915-4023 |
Second Address | Garfield Heights, OH 44125-2964 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 29/08/2006 |
Last Update Date | 14/08/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0339691 | (05) | OH |