Provider Demographics
NPI:1619464740
Name:GAFFNEY, KARYN COLLEEN (PA-C)
Entity Type:Individual
Prefix:
First Name:KARYN
Middle Name:COLLEEN
Last Name:GAFFNEY
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:KARYN
Other - Middle Name:COLLEEN
Other - Last Name:MONAHAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:506 6TH AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11215-4905
Mailing Address - Country:US
Mailing Address - Phone:718-246-8610
Mailing Address - Fax:
Practice Address - Street 1:506 6TH AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11215-4905
Practice Address - Country:US
Practice Address - Phone:718-246-8610
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-14
Last Update Date:2018-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY021931363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant