1699674259 NPI number — KAREN R MIROCHNIK NURSE PRACTITIONE

Table of content: KAREN R MIROCHNIK NURSE PRACTITIONE (NPI 1699674259)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1699674259 NPI number — KAREN R MIROCHNIK NURSE PRACTITIONE

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MIROCHNIK
Provider First Name:
KAREN
Provider Middle Name:
R
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
NURSE PRACTITIONE
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1699674259
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/02/2026
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2606 HARING ST. 2ND FL
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BROOKLYN
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
11235
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
917-501-0064
Provider Business Mailing Address Fax Number:
718-360-2279

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2935 WEST 5TH ST.
Provider Second Line Business Practice Location Address:
19F
Provider Business Practice Location Address City Name:
BROOKLYN
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11224
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
347-886-2048
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
11/02/2026

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: 363L00000X , with the licence number:  353990 , 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)





Copyright © 2007-2026 www.npivalidator.com