Provider Demographics
NPI:1700894177
Name:KARLIN, ROGER H (MD)
Entity Type:Individual
Prefix:
First Name:ROGER
Middle Name:H
Last Name:KARLIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:88 ROUTE 37
Mailing Address - Street 2:
Mailing Address - City:NEW FAIRFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06812
Mailing Address - Country:US
Mailing Address - Phone:203-746-2436
Mailing Address - Fax:203-746-3205
Practice Address - Street 1:88 ROUTE 37
Practice Address - Street 2:
Practice Address - City:NEW FAIRFIELD
Practice Address - State:CT
Practice Address - Zip Code:06812
Practice Address - Country:US
Practice Address - Phone:203-746-2436
Practice Address - Fax:203-746-3205
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-03
Last Update Date:2010-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT19394207K00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
Provider Identifiers
StateIdentifier IDID TypeIssuer
529936OtherAETNA
P377391OtherOXFORD
040363OtherHEALTH NET
2010059OtherAETNA
D02821Medicare UPIN
P377391OtherOXFORD