Provider Demographics
NPI:1629017330
Name:DAHLMAN, KAREN (PHD)
Entity Type:Individual
Prefix:DR
First Name:KAREN
Middle Name:
Last Name:DAHLMAN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 E 94TH ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10128-1913
Mailing Address - Country:US
Mailing Address - Phone:212-828-4780
Mailing Address - Fax:212-828-4781
Practice Address - Street 1:5 E 94TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10128-1913
Practice Address - Country:US
Practice Address - Phone:212-828-4780
Practice Address - Fax:212-828-4781
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-06
Last Update Date:2012-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY012783103G00000X, 103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYP532386OtherOXFORD NON-PARTICIPATING
NYV31801Medicare PIN
NYP532386OtherOXFORD NON-PARTICIPATING