Provider Demographics
NPI:1952563918
Name:SMITH, KAREN (DO)
Entity Type:Individual
Prefix:DR
First Name:KAREN
Middle Name:
Last Name:SMITH
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1019 BROADWAY
Mailing Address - Street 2:
Mailing Address - City:WEST LONG BRANCH
Mailing Address - State:NJ
Mailing Address - Zip Code:07764-1326
Mailing Address - Country:US
Mailing Address - Phone:732-229-6797
Mailing Address - Fax:732-229-3547
Practice Address - Street 1:1019 BROADWAY
Practice Address - Street 2:
Practice Address - City:WEST LONG BRANCH
Practice Address - State:NJ
Practice Address - Zip Code:07764-1326
Practice Address - Country:US
Practice Address - Phone:732-229-6797
Practice Address - Fax:732-229-3547
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-30
Last Update Date:2019-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MB09004000207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology