Provider Demographics
NPI:1396847117
Name:PAUL, KAREN ESTHER (P A)
Entity Type:Individual
Prefix:MRS
First Name:KAREN
Middle Name:ESTHER
Last Name:PAUL
Suffix:
Gender:F
Credentials:P A
Other - Prefix:MS
Other - First Name:KAREN
Other - Middle Name:ESTHER
Other - Last Name:ATHERLY-WARD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:75 CRYSTAL RUN RD
Mailing Address - Street 2:BUILDING B, SUITE 220
Mailing Address - City:MIDDLETOWN
Mailing Address - State:NY
Mailing Address - Zip Code:10941-7000
Mailing Address - Country:US
Mailing Address - Phone:845-467-6998
Mailing Address - Fax:845-692-0675
Practice Address - Street 1:75 CRYSTAL RUN RD
Practice Address - Street 2:BUILDING B, SUITE 220
Practice Address - City:MIDDLETOWN
Practice Address - State:NY
Practice Address - Zip Code:10941-7000
Practice Address - Country:US
Practice Address - Phone:888-350-1368
Practice Address - Fax:845-692-0675
Is Sole Proprietor?:No
Enumeration Date:2006-09-02
Last Update Date:2021-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYWEA041Medicare ID - Type UnspecifiedGROUP NUMBER