Provider Demographics
NPI:1528070596
Name:TAFT, KAREN (RPA)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:
Last Name:TAFT
Suffix:
Gender:F
Credentials:RPA
Other - Prefix:
Other - First Name:KAREN
Other - Middle Name:
Other - Last Name:GRIFFIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5010 STATE HIGHWAY 30
Mailing Address - Street 2:SUITE 205
Mailing Address - City:AMSTERDAM
Mailing Address - State:NY
Mailing Address - Zip Code:12010-7532
Mailing Address - Country:US
Mailing Address - Phone:518-842-2663
Mailing Address - Fax:518-842-4861
Practice Address - Street 1:5010 STATE HIGHWAY 30
Practice Address - Street 2:SUITE 205
Practice Address - City:AMSTERDAM
Practice Address - State:NY
Practice Address - Zip Code:12010-7532
Practice Address - Country:US
Practice Address - Phone:518-842-2663
Practice Address - Fax:518-842-4861
Is Sole Proprietor?:No
Enumeration Date:2006-08-11
Last Update Date:2017-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY011351363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY000412402001OtherBS NENY
NYJ400073679OtherMEDICARE
NY390561OtherMVP
NY01558158Medicaid
NY01558158Medicaid
NY390561OtherMVP