Provider Demographics
NPI:1467560151
Name:PARK, KAREN MARIE (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:KAREN
Middle Name:MARIE
Last Name:PARK
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:70 SMITH PARK HILL RD
Mailing Address - Street 2:
Mailing Address - City:LIVINGSTON MANOR
Mailing Address - State:NY
Mailing Address - Zip Code:12758-5545
Mailing Address - Country:US
Mailing Address - Phone:914-799-1105
Mailing Address - Fax:
Practice Address - Street 1:CASTLE POINT CAMPUS (ROUTE 9D), PHARMACY (119)
Practice Address - Street 2:VA HUDSON VALLEY HEALTH CARE SYSTEM
Practice Address - City:WAPPINGERS FALLS
Practice Address - State:NY
Practice Address - Zip Code:12590
Practice Address - Country:US
Practice Address - Phone:845-831-2000
Practice Address - Fax:845-838-5189
Is Sole Proprietor?:No
Enumeration Date:2006-08-25
Last Update Date:2017-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0492101835G0303X, 1835P0018X, 1835P2201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P2201XPharmacy Service ProvidersPharmacistAmbulatory Care
No1835G0303XPharmacy Service ProvidersPharmacistGeriatric
No1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist