Basic Information
| Provider Information | |||||||||
| NPI: | 1356372189 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MARTIN | ||||||||
| FirstName: | KAREN | ||||||||
| MiddleName: | LESLIE | ||||||||
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| Mailing Information | |||||||||
| Address1: | 42 MEADOW LN | ||||||||
| Address2: | |||||||||
| City: | PLEASANTVILLE | ||||||||
| State: | NY | ||||||||
| PostalCode: | 105703239 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9147697942 | ||||||||
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| Practice Location | |||||||||
| Address1: | 3 BARKER AVE | ||||||||
| Address2: | 4TH FLOOR | ||||||||
| City: | WHITE PLAINS | ||||||||
| State: | NY | ||||||||
| PostalCode: | 106011509 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9149491199 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/06/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | F332422-1 | NY | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.