Provider Demographics
NPI:1982675765
Name:LAFACE, KAREN M (MD)
Entity Type:Individual
Prefix:DR
First Name:KAREN
Middle Name:M
Last Name:LAFACE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:950 DANBY RD STE 100-A2
Mailing Address - Street 2:
Mailing Address - City:ITHACA
Mailing Address - State:NY
Mailing Address - Zip Code:14850-5778
Mailing Address - Country:US
Mailing Address - Phone:607-391-2577
Mailing Address - Fax:888-987-8119
Practice Address - Street 1:950 DANBY RD STE 100-A2
Practice Address - Street 2:
Practice Address - City:ITHACA
Practice Address - State:NY
Practice Address - Zip Code:14850-5778
Practice Address - Country:US
Practice Address - Phone:607-391-2577
Practice Address - Fax:888-987-8119
Is Sole Proprietor?:No
Enumeration Date:2006-01-30
Last Update Date:2024-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY216054207P00000X
NY216054-1207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02008799Medicaid
PA0017717300001Medicaid
NYCC2069Medicare ID - Type Unspecified
H07128Medicare UPIN
PA0017717300001Medicaid