1508939612 NPI number — KAREN MILLER PECHMAN MD

Table of content: KAREN MILLER PECHMAN MD (NPI 1508939612)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1508939612 NPI number — KAREN MILLER PECHMAN MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
PECHMAN
Provider First Name:
KAREN
Provider Middle Name:
MILLER
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
MILLER
Provider Other First Name:
KAREN
Provider Other Middle Name:
MARCY
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
MD
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1508939612
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/26/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
170 MAPLE AVENUE
Provider Second Line Business Mailing Address:
SUITE 510
Provider Business Mailing Address City Name:
WHITE PLAINS
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
10601
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
914-683-0020
Provider Business Mailing Address Fax Number:
914-683-0402

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
170 MAPLE AVENUE
Provider Second Line Business Practice Location Address:
SUITE 510
Provider Business Practice Location Address City Name:
WHITE PLAINS
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10601
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
914-683-0020
Provider Business Practice Location Address Fax Number:
914-683-0402
Provider Enumeration Date:
11/16/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 208100000X , with the licence number:  1603631 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 1603638B . This is a "WORK COMP." identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".