Individual provider · Type 1 NPI

Otar Koniashvili, MD

Student in an Organized Health Care Education/Training Program · Stony Brook, NY

NPI number 1316739600 Active

Practice location

101 Nicolls Road, Hsc T-11, Room 040
Stony Brook, NY 11794-8111

Call (631) 444-2020 Map

Fax (631) 444-2894

Specialties and licenses

TaxonomyCodeLicense
Student in an Organized Health Care Education/Training Program Primary 390200000XNone listed

Student in an Organized Health Care Education/Training Program: An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

69 other providers at this address

Other student in an organized health care education/training program providers in Stony Brook

See all in Stony Brook →

About NPI 1316739600

Otar Koniashvili, MD's National Provider Identifier is 1316739600, issued on May 21, 2025. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in Stony Brook, NY. The record was last updated on Feb 26, 2026.