Provider Demographics
NPI:1083890859
Name:FIERO, KAREN B
Entity Type:Individual
Prefix:MRS
First Name:KAREN
Middle Name:B
Last Name:FIERO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 818
Mailing Address - Street 2:
Mailing Address - City:MIDDLEBURGH
Mailing Address - State:NY
Mailing Address - Zip Code:12122-0818
Mailing Address - Country:US
Mailing Address - Phone:518-487-1842
Mailing Address - Fax:
Practice Address - Street 1:673 E MAIN ST
Practice Address - Street 2:
Practice Address - City:COBLESKILL
Practice Address - State:NY
Practice Address - Zip Code:12043-3824
Practice Address - Country:US
Practice Address - Phone:518-234-4096
Practice Address - Fax:518-234-2171
Is Sole Proprietor?:No
Enumeration Date:2008-01-11
Last Update Date:2008-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY037644183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00917024Medicaid