Provider Demographics
NPI:1649200239
Name:RUSSO-STEIGLITZ, KAREN (MD)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:
Last Name:RUSSO-STEIGLITZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:70 E 90TH ST
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10128-1233
Mailing Address - Country:US
Mailing Address - Phone:212-722-7409
Mailing Address - Fax:212-722-7185
Practice Address - Street 1:15 ESSEX RD
Practice Address - Street 2:
Practice Address - City:PARAMUS
Practice Address - State:NJ
Practice Address - Zip Code:07652-1451
Practice Address - Country:US
Practice Address - Phone:212-722-7409
Practice Address - Fax:212-722-7185
Is Sole Proprietor?:No
Enumeration Date:2006-07-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJG61517Medicare UPIN
NJ60896Medicare ID - Type Unspecified