Basic Information
Provider Information
NPI: 1356467575
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: MCLEAN
FirstName: KAREN
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential: M.D., PH.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: ELM AND CARLTON ST
Address2:  
City: BUFFALO
State: NY
PostalCode: 142632300
CountryCode: US
TelephoneNumber: 7168452300
FaxNumber:  
Practice Location
Address1: ELM AND CARLTON ST
Address2:  
City: BUFFALO
State: NY
PostalCode: 142630001
CountryCode: US
TelephoneNumber: 7168452300
FaxNumber: 7168453549
Other Information
ProviderEnumerationDate: 03/21/2007
LastUpdateDate: 07/10/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 07/10/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207V00000X4301083778MIN Allopathic & Osteopathic PhysiciansObstetrics & Gynecology 
207VX0201X4301083778MIN Allopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologic Oncology
207VX0201X207VX0201XNYY Allopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologic Oncology

No ID Information.


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