Provider Demographics
NPI:1710221072
Name:KARNICH, LIZA (MSED)
Entity Type:Individual
Prefix:MRS
First Name:LIZA
Middle Name:
Last Name:KARNICH
Suffix:
Gender:F
Credentials:MSED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 HALF HOLLOW RD
Mailing Address - Street 2:
Mailing Address - City:HOLBROOK
Mailing Address - State:NY
Mailing Address - Zip Code:11741-3706
Mailing Address - Country:US
Mailing Address - Phone:631-793-2297
Mailing Address - Fax:
Practice Address - Street 1:6 HALF HOLLOW RD
Practice Address - Street 2:
Practice Address - City:HOLBROOK
Practice Address - State:NY
Practice Address - Zip Code:11741-3706
Practice Address - Country:US
Practice Address - Phone:631-793-2297
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-26
Last Update Date:2012-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist