Provider Demographics
NPI:1962432419
Name:JOSEPH, KAREEN (MD)
Entity type:Individual
Prefix:DR
First Name:KAREEN
Middle Name:
Last Name:JOSEPH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4209 28TH ST # CN48
Mailing Address - Street 2:
Mailing Address - City:LONG ISLAND CITY
Mailing Address - State:NY
Mailing Address - Zip Code:11101-4130
Mailing Address - Country:US
Mailing Address - Phone:347-396-6299
Mailing Address - Fax:347-396-6367
Practice Address - Street 1:1309 FULTON AVE
Practice Address - Street 2:1ST FLOOR
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10456-2403
Practice Address - Country:US
Practice Address - Phone:718-838-6876
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-03
Last Update Date:2024-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY193839 1207R00000X
NY193839207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01056PMedicare ID - Type UnspecifiedGHI
NY01056QMedicare ID - Type UnspecifiedGHI
NY935571Medicare ID - Type UnspecifiedEMPIRE
H89733Medicare UPIN