Provider Demographics
NPI:1518228584
Name:ESCOBAR, KARLA
Entity Type:Individual
Prefix:MS
First Name:KARLA
Middle Name:
Last Name:ESCOBAR
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 1:9815 HORACE HARDING EXPY APT 7B
Mailing Address - Street 2:
Mailing Address - City:CORONA
Mailing Address - State:NY
Mailing Address - Zip Code:11368-4208
Mailing Address - Country:US
Mailing Address - Phone:917-579-7004
Mailing Address - Fax:
Practice Address - Street 1:9815 HORACE HARDING EXPY APT 7B
Practice Address - Street 2:
Practice Address - City:CORONA
Practice Address - State:NY
Practice Address - Zip Code:11368-4208
Practice Address - Country:US
Practice Address - Phone:917-579-7004
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-06
Last Update Date:2012-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator