Provider Demographics
NPI:1891198529
Name:FITTINGHOFF, KAREN
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:
Last Name:FITTINGHOFF
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:473 W END AVE
Mailing Address - Street 2:APT. 8B
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10024-4934
Mailing Address - Country:US
Mailing Address - Phone:914-671-3708
Mailing Address - Fax:
Practice Address - Street 1:473 W END AVE
Practice Address - Street 2:APT. 8B
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10024-4934
Practice Address - Country:US
Practice Address - Phone:914-671-3708
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-08
Last Update Date:2014-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist