Provider Demographics
NPI:1144338559
Name:KONIG, ERIC L (DC)
Entity type:Individual
Prefix:MR
First Name:ERIC
Middle Name:L
Last Name:KONIG
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:313 BRIDLE PATH RD
Mailing Address - Street 2:
Mailing Address - City:LANSDALE
Mailing Address - State:PA
Mailing Address - Zip Code:19446-1565
Mailing Address - Country:US
Mailing Address - Phone:609-203-1317
Mailing Address - Fax:
Practice Address - Street 1:601 E MAIN ST
Practice Address - Street 2:
Practice Address - City:LANSDALE
Practice Address - State:PA
Practice Address - Zip Code:19446
Practice Address - Country:US
Practice Address - Phone:215-362-1212
Practice Address - Fax:215-362-2133
Is Sole Proprietor?:No
Enumeration Date:2006-08-26
Last Update Date:2008-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00282700111N00000X
PADC009035111N00000X
NYX003744-1111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
V01448Medicare UPIN
NJ083681R50Medicare ID - Type Unspecified