Provider Demographics
NPI:1326071382
Name:POLS, KAREN BIRGIT (MD)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:BIRGIT
Last Name:POLS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 KINGS HWY
Mailing Address - Street 2:
Mailing Address - City:HAUPPAUGE
Mailing Address - State:NY
Mailing Address - Zip Code:11788-4216
Mailing Address - Country:US
Mailing Address - Phone:631-348-4900
Mailing Address - Fax:631-348-0273
Practice Address - Street 1:1 KINGS HWY
Practice Address - Street 2:
Practice Address - City:HAUPPAUGE
Practice Address - State:NY
Practice Address - Zip Code:11788-4216
Practice Address - Country:US
Practice Address - Phone:631-348-4900
Practice Address - Fax:631-348-0273
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY197600207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYG87985Medicare UPIN
NY5112D1Medicare ID - Type Unspecified
NY0295DCMedicare ID - Type Unspecified