Provider Demographics
NPI:1194993808
Name:KAREN NIELSEN, D.O.
Entity type:Organization
Organization Name:KAREN NIELSEN, D.O.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:
Authorized Official - Last Name:NIELSEN
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:215-253-7263
Mailing Address - Street 1:91 E 4TH ST
Mailing Address - Street 2:#2
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10003-9000
Mailing Address - Country:US
Mailing Address - Phone:215-459-8557
Mailing Address - Fax:215-599-7986
Practice Address - Street 1:822 MONTGOMERY AVE
Practice Address - Street 2:SUITE 315
Practice Address - City:NARBERTH
Practice Address - State:PA
Practice Address - Zip Code:19072-1937
Practice Address - Country:US
Practice Address - Phone:610-667-4601
Practice Address - Fax:610-667-6416
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-15
Last Update Date:2008-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS014231261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center