Provider Demographics
NPI:1831900364
Name:SURGEON, KAREN A
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:A
Last Name:SURGEON
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:PO BOX 572
Mailing Address - Street 2:65 FLEETWOOD AVE
Mailing Address - City:MOUNT VERNON
Mailing Address - State:NY
Mailing Address - Zip Code:10552-0572
Mailing Address - Country:US
Mailing Address - Phone:347-920-6901
Mailing Address - Fax:
Practice Address - Street 1:65 FLEETWOOD AVE,
Practice Address - Street 2:PO BOX 575
Practice Address - City:MT. VERNON
Practice Address - State:NY
Practice Address - Zip Code:10552
Practice Address - Country:US
Practice Address - Phone:347-920-6901
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-15
Last Update Date:2025-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula