Provider Demographics
NPI:1164845301
Name:BIFULCO, KAREN I (RN)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:I
Last Name:BIFULCO
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3091 CORLEAR DR
Mailing Address - Street 2:
Mailing Address - City:BALDWINSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:13027-8922
Mailing Address - Country:US
Mailing Address - Phone:315-303-5643
Mailing Address - Fax:
Practice Address - Street 1:3091 CORLEAR DR
Practice Address - Street 2:
Practice Address - City:BALDWINSVILLE
Practice Address - State:NY
Practice Address - Zip Code:13027-8922
Practice Address - Country:US
Practice Address - Phone:315-303-5643
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-23
Last Update Date:2014-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY441596163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse