Provider Demographics
NPI:1467474536
Name:ZIEMKE, KAREN SUE (MD)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:SUE
Last Name:ZIEMKE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:745 NORTHFIELD AVENUE
Mailing Address - Street 2:SUITE 4
Mailing Address - City:WEST ORANGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07052-1144
Mailing Address - Country:US
Mailing Address - Phone:973-736-0041
Mailing Address - Fax:973-736-0044
Practice Address - Street 1:745 NORTHFIELD AVENUE
Practice Address - Street 2:SUITE 4
Practice Address - City:WEST ORANGE
Practice Address - State:NJ
Practice Address - Zip Code:07052-1144
Practice Address - Country:US
Practice Address - Phone:973-716-0041
Practice Address - Fax:973-716-0042
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-24
Last Update Date:2013-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA60442207KA0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207KA0200XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyAllergy
Provider Identifiers
StateIdentifier IDID TypeIssuer
530458Medicare ID - Type Unspecified
F90180Medicare UPIN