Provider Demographics
NPI:1447218193
Name:GALICHON, KAREN H (MD,)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:H
Last Name:GALICHON
Suffix:
Gender:F
Credentials:MD,
Other - Prefix:
Other - First Name:KAREN
Other - Middle Name:
Other - Last Name:HOLLADAY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 95000-2454
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19195-2454
Mailing Address - Country:US
Mailing Address - Phone:212-352-2600
Mailing Address - Fax:
Practice Address - Street 1:309 W 23RD ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10011-2202
Practice Address - Country:US
Practice Address - Phone:212-352-2600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-03
Last Update Date:2014-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY206370207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02187951Medicaid
NY56N511Medicare ID - Type Unspecified
NYG88888Medicare UPIN