Provider Demographics
NPI:1407914542
Name:DIAS-MARTIN, KAREN ARLENE (MD)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:ARLENE
Last Name:DIAS-MARTIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:200 HIGHLAND AVE
Mailing Address - Street 2:SUITE 230
Mailing Address - City:GLEN RIDGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07028-1528
Mailing Address - Country:US
Mailing Address - Phone:973-743-8585
Mailing Address - Fax:973-743-1549
Practice Address - Street 1:200 HIGHLAND AVE
Practice Address - Street 2:SUITE 230
Practice Address - City:GLEN RIDGE
Practice Address - State:NJ
Practice Address - Zip Code:07028-1528
Practice Address - Country:US
Practice Address - Phone:973-743-8585
Practice Address - Fax:973-743-1549
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-04
Last Update Date:2020-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA05696100207VG0400X, 207VX0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
Not Answered207VX0000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyObstetrics