Provider Demographics
NPI:1477379196
Name:FRAZER, KAREN
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:
Last Name:FRAZER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1975 UNION ST APT 2C
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11233-5256
Mailing Address - Country:US
Mailing Address - Phone:347-864-3525
Mailing Address - Fax:
Practice Address - Street 1:2911 QUEENS PLZ N FL 5TH
Practice Address - Street 2:
Practice Address - City:LONG ISLAND CITY
Practice Address - State:NY
Practice Address - Zip Code:11101-4034
Practice Address - Country:US
Practice Address - Phone:717-391-8300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-26
Last Update Date:2024-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY613780163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool