Provider Demographics
NPI:1992793137
Name:FLICK, KAREN C (NP)
Entity type:Individual
Prefix:MS
First Name:KAREN
Middle Name:C
Last Name:FLICK
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:1729 BURRSTONE RD
Mailing Address - Street 2:
Mailing Address - City:NEW HARTFORD
Mailing Address - State:NY
Mailing Address - Zip Code:13413-1001
Mailing Address - Country:US
Mailing Address - Phone:315-798-1500
Mailing Address - Fax:315-798-1710
Practice Address - Street 1:117 BUSINESS PARK DR
Practice Address - Street 2:
Practice Address - City:UTICA
Practice Address - State:NY
Practice Address - Zip Code:13502-6303
Practice Address - Country:US
Practice Address - Phone:315-798-1866
Practice Address - Fax:315-798-1586
Is Sole Proprietor?:No
Enumeration Date:2005-10-12
Last Update Date:2023-06-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY300458363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02312054Medicaid
RA0907Medicare ID - Type Unspecified
NY02312054Medicaid