Provider Demographics
NPI:1417943226
Name:WHITE, KAREN MECHELE (DPM)
Entity type:Individual
Prefix:DR
First Name:KAREN
Middle Name:MECHELE
Last Name:WHITE
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:531 NEW HAVEN AVE
Mailing Address - Street 2:
Mailing Address - City:MILFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06460-8613
Mailing Address - Country:US
Mailing Address - Phone:203-877-4469
Mailing Address - Fax:203-878-8849
Practice Address - Street 1:1505 BARNUM AVE
Practice Address - Street 2:
Practice Address - City:STRATFORD
Practice Address - State:CT
Practice Address - Zip Code:06614-5404
Practice Address - Country:US
Practice Address - Phone:203-877-4469
Practice Address - Fax:203-878-8849
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-27
Last Update Date:2010-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CTCT000679213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT030000679CT07OtherBCBS
CT030000679CT08OtherBCBS
CT4180668Medicaid
CT4180668Medicaid
CT030000679CT08OtherBCBS