Provider Demographics
NPI:1174634232
Name:DEASEY, KAREN KULIK (MD)
Entity Type:Individual
Prefix:DR
First Name:KAREN
Middle Name:KULIK
Last Name:DEASEY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:KAREN
Other - Middle Name:KULIK
Other - Last Name:LIPINSKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:875 COUNTY LINE RD
Mailing Address - Street 2:BRYN MAWR MEDICAL BLDG SOUTH SUITE 207
Mailing Address - City:BRYN MAWR
Mailing Address - State:PA
Mailing Address - Zip Code:19010-3113
Mailing Address - Country:US
Mailing Address - Phone:610-525-1920
Mailing Address - Fax:610-525-8395
Practice Address - Street 1:875 COUNTY LINE RD
Practice Address - Street 2:BRYN MAWR MEDICAL BLDG SOUTH SUITE 207
Practice Address - City:BRYN MAWR
Practice Address - State:PA
Practice Address - Zip Code:19010-3113
Practice Address - Country:US
Practice Address - Phone:610-525-1920
Practice Address - Fax:610-525-8393
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2010-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA019667E207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA142994Medicare ID - Type Unspecified
B39369Medicare UPIN