Provider Demographics
NPI:1447999735
Name:FILCHAK, KONNER (PA-C)
Entity type:Individual
Prefix:
First Name:KONNER
Middle Name:
Last Name:FILCHAK
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:40 TRIPP HOLLOW RD
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:CT
Mailing Address - Zip Code:06234-1624
Mailing Address - Country:US
Mailing Address - Phone:860-617-3866
Mailing Address - Fax:
Practice Address - Street 1:45 FRANCIS ST
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02115-6105
Practice Address - Country:US
Practice Address - Phone:617-732-6325
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-03
Last Update Date:2022-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant