Provider Demographics
NPI:1134318520
Name:GREENE, KAREN E (NP)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:E
Last Name:GREENE
Suffix:
Gender:F
Credentials:NP
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Mailing Address - Street 1:66 POWERHOUSE RD
Mailing Address - Street 2:3RD FLOOR
Mailing Address - City:ROSLYN HEIGHTS
Mailing Address - State:NY
Mailing Address - Zip Code:11577-1372
Mailing Address - Country:US
Mailing Address - Phone:516-945-3000
Mailing Address - Fax:516-945-3131
Practice Address - Street 1:154 COMMACK RD
Practice Address - Street 2:STE-100
Practice Address - City:COMMACK
Practice Address - State:NY
Practice Address - Zip Code:11725-3457
Practice Address - Country:US
Practice Address - Phone:631-499-8282
Practice Address - Fax:631-452-5462
Is Sole Proprietor?:No
Enumeration Date:2007-10-22
Last Update Date:2009-02-10
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Provider Licenses
StateLicense IDTaxonomies
NY255092163W00000X
NYF380990363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03057072Medicaid