Provider Demographics
NPI:1629331327
Name:JAKUBOWICZ, KAREN
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:
Last Name:JAKUBOWICZ
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 1:13642 71ST RD
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11367-1943
Mailing Address - Country:US
Mailing Address - Phone:718-263-3873
Mailing Address - Fax:
Practice Address - Street 1:72-38 MAIN STREET
Practice Address - Street 2:CHALLENGE EI
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11367
Practice Address - Country:US
Practice Address - Phone:718-851-3300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-19
Last Update Date:2012-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator