Doctor Name: | KAREN MARIE MICKALIGER |
NPI Number: | 1104124353 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | REGISTERED NURSE |
License Number: | 330756-1 |
Business Practice Address: | 1225 Ostrander Ave Riverhead, NY - 119012108 |
Business Phone Number: | 6317275900 |
Business Fax Number: | 6317278483 |
Mailing Address: | 700 Osborne Ave, RIVERHEAD |
State: | NY |
Postal Code: | 119012912 |
Phone Number: | 6317275900 |
Fax Number: | 6317278483 |
NPI Enumeration Date: | 03/10/2011 |
NPI Last Update Date: | 03/10/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 163WS0200X |
License Number: | 330756-1 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
Taxonomy Type: | Nursing Service Providers |
Taxonomy Classification: | Registered Nurse |
Taxonomy Specialization: | School |
Taxonomy Definition: |