Provider Demographics
NPI:1437544814
Name:PINDER, KAREN
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:
Last Name:PINDER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17607 93RD AVE
Mailing Address - Street 2:2FL
Mailing Address - City:JAMAICA
Mailing Address - State:NY
Mailing Address - Zip Code:11433-1327
Mailing Address - Country:US
Mailing Address - Phone:347-448-7270
Mailing Address - Fax:
Practice Address - Street 1:17607 93RD AVE
Practice Address - Street 2:2FL
Practice Address - City:JAMAICA
Practice Address - State:NY
Practice Address - Zip Code:11433-1327
Practice Address - Country:US
Practice Address - Phone:347-448-7270
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-01
Last Update Date:2015-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY320281-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY8778609UPDMedicaid