Basic Information
Provider Information
NPI: 1487738316
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SCHICK
FirstName: KAREN
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
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OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 711 TROY SCHENECTADY RD
Address2: SUITE 201
City: LATHAM
State: NY
PostalCode: 121102442
CountryCode: US
TelephoneNumber:  
FaxNumber:  
Practice Location
Address1: 1 WEST AVE
Address2: SUITE 305
City: SARATOGA SPRINGS
State: NY
PostalCode: 128666045
CountryCode: US
TelephoneNumber: 5185871553
FaxNumber:  
Other Information
ProviderEnumerationDate: 10/25/2006
LastUpdateDate: 10/06/2014
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207VG0400X182310NYY Allopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology

ID Information
IDTypeStateIssuerDescription
0125788105NY MEDICAID


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