Provider Demographics
NPI:1295856243
Name:KAREN P. SZCZECHOWICZ M.D., PC
Entity Type:Organization
Organization Name:KAREN P. SZCZECHOWICZ M.D., PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:PATRICIA
Authorized Official - Last Name:SZCZECHOWICZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:978-538-3131
Mailing Address - Street 1:39 CROSS ST
Mailing Address - Street 2:SUITE 306
Mailing Address - City:PEABODY
Mailing Address - State:MA
Mailing Address - Zip Code:01960-1670
Mailing Address - Country:US
Mailing Address - Phone:978-538-3131
Mailing Address - Fax:978-538-1909
Practice Address - Street 1:39 CROSS ST
Practice Address - Street 2:SUITE 306
Practice Address - City:PEABODY
Practice Address - State:MA
Practice Address - Zip Code:01960-1670
Practice Address - Country:US
Practice Address - Phone:978-538-3131
Practice Address - Fax:978-538-1909
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-03
Last Update Date:2011-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA80041208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA9701630Medicaid