Provider Demographics
NPI:1740361377
Name:SMREK, KAREN VICTORIA (NP)
Entity type:Individual
Prefix:MRS
First Name:KAREN
Middle Name:VICTORIA
Last Name:SMREK
Suffix:
Gender:F
Credentials:NP
Other - Prefix:MRS
Other - First Name:KAREN
Other - Middle Name:VICTORIA
Other - Last Name:GARLAND-SMREK
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:NP
Mailing Address - Street 1:205 GLENWOOD LN
Mailing Address - Street 2:
Mailing Address - City:PORT JEFFERSON
Mailing Address - State:NY
Mailing Address - Zip Code:11777-1506
Mailing Address - Country:US
Mailing Address - Phone:631-476-5701
Mailing Address - Fax:
Practice Address - Street 1:STONY BROOK UNIVERSITY MEDICAL CTR
Practice Address - Street 2:T-19,HSC,ROOM 080
Practice Address - City:STONY BROOK
Practice Address - State:NY
Practice Address - Zip Code:11794
Practice Address - Country:US
Practice Address - Phone:631-444-1820
Practice Address - Fax:631-444-8963
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-18
Last Update Date:2018-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY302950363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner