Provider Demographics
NPI:1144308115
Name:KONLIAN, DONNA MARIE (MD, FACC)
Entity type:Individual
Prefix:DR
First Name:DONNA
Middle Name:MARIE
Last Name:KONLIAN
Suffix:
Gender:F
Credentials:MD, FACC
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:246 HAMBURG TPKE
Mailing Address - Street 2:SUITE 201
Mailing Address - City:WAYNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07470-2156
Mailing Address - Country:US
Mailing Address - Phone:973-942-1141
Mailing Address - Fax:973-942-1250
Practice Address - Street 1:246 HAMBURG TPKE
Practice Address - Street 2:SUITE 201
Practice Address - City:WAYNE
Practice Address - State:NJ
Practice Address - Zip Code:07470-2156
Practice Address - Country:US
Practice Address - Phone:973-942-1141
Practice Address - Fax:973-942-1250
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2010-04-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MA06496000207RC0000X, 207UN0901X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207UN0901XAllopathic & Osteopathic PhysiciansNuclear MedicineNuclear Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ7134606Medicaid
NJ7134606Medicaid
NJG14964Medicare UPIN