Jennifer Ann Kondolf-Duba, OTR/L

Primary specialty

Pediatric Occupational TherapistTaxonomy code 225XP0200X

License

002008-1 Issued in NY

Practice address

96 W Gibson St
Canandaigua, NY 14424-1453

Phone

(585) 396-3930

NPI assigned

Sep 14, 2011

Last updated

Sep 14, 2011By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1315958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1315958400000",
    "number": "1609158823",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5910 JONES RD",
            "city": "CANANDAIGUA",
            "state": "NY",
            "postal_code": "144248924"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "96 W GIBSON ST",
            "city": "CANANDAIGUA",
            "state": "NY",
            "postal_code": "144241453",
            "telephone_number": "585-396-3930"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KONDOLF-DUBA",
        "first_name": "JENNIFER",
        "middle_name": "ANN",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-09-14",
        "last_updated": "2011-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "NY",
            "license": "002008-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "638130116",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Dawn Kneut, LPN
• Wonkyung Kniffen
• Kristin L. Koberstein, LMFT
• Gary G Kochersberger, M.D.
• Shelby Koerner, LMHC, LPCC
• Leanne S Kontur
• Matthew Ryan Koss
• Mel M Kost, PHARMACIST
• Joseph Brian Kostecki, MT-BC
• Elizabeth Anne Koster, CCC SLP

• Pediatric Occupational Therapist in Canandaigua, NY
• Providers in Canandaigua, NY by specialty
• Pediatric Occupational Therapist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.