Provider Demographics
NPI:1992766174
Name:KONRAD, HINDOLA (MD)
Entity type:Individual
Prefix:
First Name:HINDOLA
Middle Name:
Last Name:KONRAD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:164 MOUNT PLEASANT RD STE 201
Mailing Address - Street 2:
Mailing Address - City:NEWTOWN
Mailing Address - State:CT
Mailing Address - Zip Code:06470-1475
Mailing Address - Country:US
Mailing Address - Phone:203-297-6869
Mailing Address - Fax:203-491-2223
Practice Address - Street 1:164 MOUNT PLEASANT RD STE 201
Practice Address - Street 2:
Practice Address - City:NEWTOWN
Practice Address - State:CT
Practice Address - Zip Code:06470-1475
Practice Address - Country:US
Practice Address - Phone:203-297-6869
Practice Address - Fax:203-491-2223
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-29
Last Update Date:2025-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY200770-1207W00000X
CT037958207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT001379587Medicaid
CTP2577527OtherOXFORD
CT180000962Medicare ID - Type Unspecified
CT001379587Medicaid
NYW88091Medicare PIN