Provider Demographics
NPI:1508818071
Name:DAVID, KAREN L
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:L
Last Name:DAVID
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1901 1ST AVE
Mailing Address - Street 2:METROPOLITAN HOSPITAL ROOM 523
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10029-7404
Mailing Address - Country:US
Mailing Address - Phone:212-423-6452
Mailing Address - Fax:212-423-7697
Practice Address - Street 1:1901 1ST AVE
Practice Address - Street 2:METROPOLITAN HOSPITAL ROOM 523
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10029-7404
Practice Address - Country:US
Practice Address - Phone:212-423-6452
Practice Address - Fax:212-423-7697
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-16
Last Update Date:2007-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY127109207SG0201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207SG0201XAllopathic & Osteopathic PhysiciansMedical GeneticsClinical Genetics (M.D.)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00250142Medicaid
G62764Medicare UPIN
NY00250142Medicaid