Provider Demographics
NPI:1770636722
Name:KARUSH, M.D., NATHANIEL P (MD)
Entity Type:Individual
Prefix:
First Name:NATHANIEL
Middle Name:P
Last Name:KARUSH, M.D.
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:35 E 85TH ST
Mailing Address - Street 2:APT 12 DN
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10028-0954
Mailing Address - Country:US
Mailing Address - Phone:212-249-6228
Mailing Address - Fax:212-628-5333
Practice Address - Street 1:35 E 85TH ST
Practice Address - Street 2:APT 12 DN
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10028-0954
Practice Address - Country:US
Practice Address - Phone:212-249-6228
Practice Address - Fax:212-628-5333
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0997762084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYB17227Medicare UPIN
NY626611Medicare ID - Type Unspecified