Provider Demographics
NPI:1013209048
Name:KAREN KRITSKY DO PA
Entity Type:Organization
Organization Name:KAREN KRITSKY DO PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SHELLY
Authorized Official - Middle Name:I
Authorized Official - Last Name:DUNCAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:727-545-8769
Mailing Address - Street 1:7800 66TH ST N
Mailing Address - Street 2:STE 204
Mailing Address - City:PINELLAS PARK
Mailing Address - State:FL
Mailing Address - Zip Code:33781-2168
Mailing Address - Country:US
Mailing Address - Phone:727-545-8769
Mailing Address - Fax:727-544-1681
Practice Address - Street 1:7800 66TH ST N
Practice Address - Street 2:STE 204
Practice Address - City:PINELLAS PARK
Practice Address - State:FL
Practice Address - Zip Code:33781-2168
Practice Address - Country:US
Practice Address - Phone:727-545-8769
Practice Address - Fax:727-544-1681
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-10
Last Update Date:2012-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS0004522208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL063529400OtherMEDICAID
FL82551OtherMEDICARE PTAN