Provider Demographics
NPI:1326118514
Name:BECKER, KAREN A (MD)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:A
Last Name:BECKER
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 1:90 RIVERSIDE DR
Mailing Address - Street 2:APT. 1B
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10024-5306
Mailing Address - Country:US
Mailing Address - Phone:718-547-6111
Mailing Address - Fax:718-547-4749
Practice Address - Street 1:MMG - WILLIAMSBRIDGE
Practice Address - Street 2:3448 BOSTON ROAD
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10469
Practice Address - Country:US
Practice Address - Phone:718-547-6111
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY197525207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine