Provider Demographics
NPI:1982885554
Name:SHORTER, KAREN D
Entity Type:Individual
Prefix:DR
First Name:KAREN
Middle Name:D
Last Name:SHORTER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:KAREN
Other - Middle Name:DENISE
Other - Last Name:WATERMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD, CGP, RPH
Mailing Address - Street 1:92 SKYLINE TRL
Mailing Address - Street 2:
Mailing Address - City:HINSDALE
Mailing Address - State:MA
Mailing Address - Zip Code:01235-9390
Mailing Address - Country:US
Mailing Address - Phone:413-623-5798
Mailing Address - Fax:413-623-5798
Practice Address - Street 1:92 SKYLINE TRL
Practice Address - Street 2:
Practice Address - City:HINSDALE
Practice Address - State:MA
Practice Address - Zip Code:01235-9390
Practice Address - Country:US
Practice Address - Phone:413-623-5798
Practice Address - Fax:413-623-5798
Is Sole Proprietor?:No
Enumeration Date:2007-11-23
Last Update Date:2007-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY336051835G0303X
CT76151835G0303X
MA235841835G0303X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835G0303XPharmacy Service ProvidersPharmacistGeriatric