Provider Demographics
NPI:1376541391
Name:JOHANSSON, KARIN SIGRID (DPM)
Entity Type:Individual
Prefix:DR
First Name:KARIN
Middle Name:SIGRID
Last Name:JOHANSSON
Suffix:
Gender:F
Credentials:DPM
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Mailing Address - Street 1:252 E 112TH ST
Mailing Address - Street 2:APT. 1H
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10029-2700
Mailing Address - Country:US
Mailing Address - Phone:917-443-3145
Mailing Address - Fax:212-557-2517
Practice Address - Street 1:144 E 44TH ST
Practice Address - Street 2:3RD FLOOR
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10017-4008
Practice Address - Country:US
Practice Address - Phone:212-557-4070
Practice Address - Fax:212-490-6657
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-13
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NYN005904213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYU92328Medicare UPIN
NYPH1761Medicare ID - Type Unspecified