Provider Demographics
NPI:1164471553
Name:MOSKOWITZ, KAREN A (CRNP)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:A
Last Name:MOSKOWITZ
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:KAREN
Other - Middle Name:A
Other - Last Name:GRILLO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNP
Mailing Address - Street 1:203 CHANDLER ST
Mailing Address - Street 2:
Mailing Address - City:MILTON
Mailing Address - State:DE
Mailing Address - Zip Code:19968-1235
Mailing Address - Country:US
Mailing Address - Phone:610-442-9377
Mailing Address - Fax:
Practice Address - Street 1:804 N DUPONT BLVD
Practice Address - Street 2:
Practice Address - City:MILFORD
Practice Address - State:DE
Practice Address - Zip Code:19963-1006
Practice Address - Country:US
Practice Address - Phone:302-725-3557
Practice Address - Fax:302-725-3558
Is Sole Proprietor?:No
Enumeration Date:2006-05-10
Last Update Date:2024-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DELP-0000294363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA03111702OtherCAPITAL BLUE CROSS
PA500016419OtherPALMETTO RR
PAS61091Medicare UPIN
PA014202KJMedicare PIN
PA014202H9MMedicare PIN