Provider Demographics
NPI:1992895320
Name:KARCNIK, GREGORY (MD)
Entity type:Individual
Prefix:DR
First Name:GREGORY
Middle Name:
Last Name:KARCNIK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 COATES DR
Mailing Address - Street 2:SUITE 8
Mailing Address - City:GOSHEN
Mailing Address - State:NY
Mailing Address - Zip Code:10924-6764
Mailing Address - Country:US
Mailing Address - Phone:845-291-0999
Mailing Address - Fax:845-294-8921
Practice Address - Street 1:3 COATES DR
Practice Address - Street 2:SUITE 8
Practice Address - City:GOSHEN
Practice Address - State:NY
Practice Address - Zip Code:10924-6764
Practice Address - Country:US
Practice Address - Phone:845-291-0999
Practice Address - Fax:845-294-8921
Is Sole Proprietor?:No
Enumeration Date:2006-10-14
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY172774-12084A0401X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084A0401XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyAddiction Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY90K512Medicare ID - Type UnspecifiedMEDICARE NUMBER
NYF38216Medicare UPIN