Provider Demographics
NPI:1184898595
Name:ODRZYWOLSKI, KAREN MARIE (MD)
Entity type:Individual
Prefix:DR
First Name:KAREN
Middle Name:MARIE
Last Name:ODRZYWOLSKI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:KAREN
Other - Middle Name:
Other - Last Name:JONES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:17 LANSING STREET
Mailing Address - Street 2:AMMS, PC / CREDENTIALING OFFICE
Mailing Address - City:AUBURN
Mailing Address - State:NY
Mailing Address - Zip Code:13021-1941
Mailing Address - Country:US
Mailing Address - Phone:315-255-7438
Mailing Address - Fax:315-255-7099
Practice Address - Street 1:77 NELSON ST STE 120
Practice Address - Street 2:D/B/A NEUROLOGY SERVICES OF AUBURN
Practice Address - City:AUBURN
Practice Address - State:NY
Practice Address - Zip Code:13021-1941
Practice Address - Country:US
Practice Address - Phone:315-252-7434
Practice Address - Fax:315-253-8104
Is Sole Proprietor?:No
Enumeration Date:2008-04-16
Last Update Date:2023-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2617762084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYPENDINGMedicaid
NYPENDINGMedicare PIN