Provider Demographics
NPI:1184053670
Name:KAREN GADE-PULIDO MD, LLC
Entity type:Organization
Organization Name:KAREN GADE-PULIDO MD, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:
Authorized Official - Last Name:GADE-PULIDO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:330-596-6514
Mailing Address - Street 1:PO BOX 8047
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44711-8047
Mailing Address - Country:US
Mailing Address - Phone:800-883-6577
Mailing Address - Fax:304-485-4466
Practice Address - Street 1:1900 S UNION AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:ALLIANCE
Practice Address - State:OH
Practice Address - Zip Code:44601-4355
Practice Address - Country:US
Practice Address - Phone:330-596-6514
Practice Address - Fax:330-596-6517
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-05
Last Update Date:2013-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35070357208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty