Provider Demographics
NPI:1639143324
Name:KERR, KAROLYN R (MD)
Entity Type:Individual
Prefix:DR
First Name:KAROLYN
Middle Name:R
Last Name:KERR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:751 2ND AVE
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10017-5906
Mailing Address - Country:US
Mailing Address - Phone:212-599-5555
Mailing Address - Fax:212-599-5554
Practice Address - Street 1:751 2ND AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10017-5906
Practice Address - Country:US
Practice Address - Phone:212-599-5555
Practice Address - Fax:212-599-5554
Is Sole Proprietor?:No
Enumeration Date:2006-02-17
Last Update Date:2008-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2055092085N0904X, 2085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
No2085N0904XAllopathic & Osteopathic PhysiciansRadiologyNuclear Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02102569Medicaid
NJ0126071Medicaid
NY97870XQTY1Medicare PIN
H25073Medicare UPIN