Provider Demographics
NPI:1568444685
Name:BACSIK, KAREN A (MD)
Entity type:Individual
Prefix:DR
First Name:KAREN
Middle Name:A
Last Name:BACSIK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1000 E GENESEE ST
Mailing Address - Street 2:SUITE 500
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13210-1892
Mailing Address - Country:US
Mailing Address - Phone:315-471-1001
Mailing Address - Fax:315-475-6056
Practice Address - Street 1:1000 E GENESEE ST
Practice Address - Street 2:SUITE 500
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13210-1892
Practice Address - Country:US
Practice Address - Phone:315-471-1001
Practice Address - Fax:315-475-6056
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-15
Last Update Date:2012-10-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY153094207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY009345382Medicaid
NY50083BMedicare ID - Type Unspecified
NYC59360Medicare UPIN