Provider Demographics
NPI:1447411210
Name:SZEWCZYK, KAREN D (CNNP)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:D
Last Name:SZEWCZYK
Suffix:
Gender:F
Credentials:CNNP
Other - Prefix:
Other - First Name:KAREN
Other - Middle Name:
Other - Last Name:CAVALLO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CNNP
Mailing Address - Street 1:110 W 6TH ST
Mailing Address - Street 2:NURSERY
Mailing Address - City:OSWEGO
Mailing Address - State:NY
Mailing Address - Zip Code:13126-2507
Mailing Address - Country:US
Mailing Address - Phone:315-349-5571
Mailing Address - Fax:315-349-5701
Practice Address - Street 1:110 W 6TH ST
Practice Address - Street 2:NURSERY
Practice Address - City:OSWEGO
Practice Address - State:NY
Practice Address - Zip Code:13126-2507
Practice Address - Country:US
Practice Address - Phone:315-349-5571
Practice Address - Fax:315-349-5701
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-24
Last Update Date:2017-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY350124363LN0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LN0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerNeonatal