Provider Demographics
NPI:1265594949
Name:LEFKOWITZ, KAREN B (MS, CNS, CDN)
Entity type:Individual
Prefix:MRS
First Name:KAREN
Middle Name:B
Last Name:LEFKOWITZ
Suffix:
Gender:F
Credentials:MS, CNS, CDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19 S PARKER DR
Mailing Address - Street 2:
Mailing Address - City:MONSEY
Mailing Address - State:NY
Mailing Address - Zip Code:10952-1602
Mailing Address - Country:US
Mailing Address - Phone:845-354-4396
Mailing Address - Fax:845-354-0694
Practice Address - Street 1:978 ROUTE 45
Practice Address - Street 2:SUITE L-7
Practice Address - City:POMONA
Practice Address - State:NY
Practice Address - Zip Code:10970-3521
Practice Address - Country:US
Practice Address - Phone:845-354-4396
Practice Address - Fax:845-354-0694
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000395-1133N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133N00000XDietary & Nutritional Service ProvidersNutritionist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY111625OtherWELLCARE OF NEW YORK
NY3472918OtherHUDSON HEALTH PLAN
9693149OtherGHI
09Q342Medicare ID - Type Unspecified
P00278937Medicare ID - Type UnspecifiedRAILROAD MEDICARE