Provider Demographics
NPI:1730103631
Name:CUMMINGS, KAREN SHARON (OD)
Entity Type:Individual
Prefix:DR
First Name:KAREN
Middle Name:SHARON
Last Name:CUMMINGS
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:751 E 89TH ST
Mailing Address - Street 2:10
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11236-3634
Mailing Address - Country:US
Mailing Address - Phone:718-272-6541
Mailing Address - Fax:718-272-6541
Practice Address - Street 1:1416 ROCKAWAY PKWY
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11236-2322
Practice Address - Country:US
Practice Address - Phone:718-257-2339
Practice Address - Fax:718-272-7171
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYT006080152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02188943Medicaid