Basic Information
Provider Information
NPI: 1023346632
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: FRANK
FirstName: KAREN
MiddleName: E
NamePrefix:  
NameSuffix:  
Credential: SLP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1020 MARY ST
Address2:  
City: UTICA
State: NY
PostalCode: 135011930
CountryCode: US
TelephoneNumber: 3157246907
FaxNumber: 3157330791
Practice Location
Address1: 1601 ARMORY DR
Address2:  
City: UTICA
State: NY
PostalCode: 135015405
CountryCode: US
TelephoneNumber: 3157988808
FaxNumber:  
Other Information
ProviderEnumerationDate: 11/20/2009
LastUpdateDate: 11/20/2009
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
235Z00000X003983NYY Speech, Language and Hearing Service ProvidersSpeech-Language Pathologist 

ID Information
IDTypeStateIssuerDescription
0047418005NY MEDICAID


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