Provider Demographics
NPI:1528169026
Name:KAREN K DEASEY MD
Entity type:Organization
Organization Name:KAREN K DEASEY MD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:KULIK
Authorized Official - Last Name:DEASEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-525-1920
Mailing Address - Street 1:945 E HAVERFORD RD STE 6
Mailing Address - Street 2:
Mailing Address - City:BRYN MAWR
Mailing Address - State:PA
Mailing Address - Zip Code:19010-3814
Mailing Address - Country:US
Mailing Address - Phone:610-527-8494
Mailing Address - Fax:610-525-8393
Practice Address - Street 1:945 E HAVERFORD RD STE 6
Practice Address - Street 2:
Practice Address - City:BRYN MAWR
Practice Address - State:PA
Practice Address - Zip Code:19010-3814
Practice Address - Country:US
Practice Address - Phone:610-525-1920
Practice Address - Fax:610-525-8393
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-26
Last Update Date:2020-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA510556Medicare ID - Type Unspecified