Provider Demographics
NPI:1295093714
Name:JANASEK, KAROLINA (MD)
Entity type:Individual
Prefix:
First Name:KAROLINA
Middle Name:
Last Name:JANASEK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:55 SOMERSET DR
Mailing Address - Street 2:
Mailing Address - City:GLENMONT
Mailing Address - State:NY
Mailing Address - Zip Code:12077-3119
Mailing Address - Country:US
Mailing Address - Phone:908-370-7024
Mailing Address - Fax:
Practice Address - Street 1:100 GREAT OAKS BLVD
Practice Address - Street 2:SUITE 103
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12203-7919
Practice Address - Country:US
Practice Address - Phone:518-464-1392
Practice Address - Fax:518-464-0445
Is Sole Proprietor?:No
Enumeration Date:2012-05-03
Last Update Date:2017-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY63206390200000X
NY280390208000000X
NJ25MA10032100208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program