Provider Demographics
NPI:1740935964
Name:KARMAN, KERI MICHELLE
Entity type:Individual
Prefix:
First Name:KERI
Middle Name:MICHELLE
Last Name:KARMAN
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 1:60 FRONT ST APT A103
Mailing Address - Street 2:
Mailing Address - City:EAST ROCKAWAY
Mailing Address - State:NY
Mailing Address - Zip Code:11518-2097
Mailing Address - Country:US
Mailing Address - Phone:516-269-0892
Mailing Address - Fax:
Practice Address - Street 1:60 FRONT ST APT A103
Practice Address - Street 2:
Practice Address - City:EAST ROCKAWAY
Practice Address - State:NY
Practice Address - Zip Code:11518-2097
Practice Address - Country:US
Practice Address - Phone:516-269-0892
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-16
Last Update Date:2022-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY404017363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health