Basic Information
| Provider Information | |||||||||
| NPI: | 1598785123 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | KARMEN | ||||||||
| FirstName: | CAROL | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 19 BRADHURST AVE | ||||||||
| Address2: | SUITE 3100N | ||||||||
| City: | HAWTHORNE | ||||||||
| State: | NY | ||||||||
| PostalCode: | 105322140 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9149099018 | ||||||||
| FaxNumber: | 9149099028 | ||||||||
| Practice Location | |||||||||
| Address1: | 19 BRADHURST AVE | ||||||||
| Address2: | SUITE 3090N | ||||||||
| City: | HAWTHORNE | ||||||||
| State: | NY | ||||||||
| PostalCode: | 105322140 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9145922400 | ||||||||
| FaxNumber: | 9145922424 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/19/2006 | ||||||||
| LastUpdateDate: | 02/27/2015 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 172688 | NY | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
ID Information
| ID | Type | State | Issuer | Description | 00000027620 | 01 | NY | GHI HMO | OTHER | 0078677 | 01 | NY | GHI PPO | OTHER | 993348 | 01 | MVP HEALTHPLAN | OTHER | 4410978 | 01 | NY | AETNA PPO | OTHER | 110063284 | 01 | RAILROAD MEDICARE | OTHER | 01201876 | 05 | NY | MEDICAID | 4C7238 | 01 | HEALTHNET | OTHER | KC2688 | 01 | ATLANTIS | OTHER | 0492102 | 01 | NY | AETNA HMO | OTHER | 172688-4W | 01 | NY | WORKERS COMPENSATION | OTHER | WP352 | 01 | OXFORD | OTHER |