Provider Demographics
NPI:1407067986
Name:MIDDLETOWN NEPHROLOGY PLLC
Entity type:Organization
Organization Name:MIDDLETOWN NEPHROLOGY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT OWNER DOCTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:A
Authorized Official - Last Name:KARIMI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:845-239-3912
Mailing Address - Street 1:14 KINGS DR
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:NY
Mailing Address - Zip Code:10941-5225
Mailing Address - Country:US
Mailing Address - Phone:845-239-3912
Mailing Address - Fax:845-883-5323
Practice Address - Street 1:14 KINGS DR
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:NY
Practice Address - Zip Code:10941-5225
Practice Address - Country:US
Practice Address - Phone:845-239-3912
Practice Address - Fax:845-883-5323
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-25
Last Update Date:2025-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
207RN0300X
NY238014208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Single Specialty
Not Answered208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03197697Medicaid
NY133AE1Medicare ID - Type Unspecified
NY02684628Medicaid