Active NPI
Karen Ann Walczak, NURSE
- Registered Nurse
- Goshen, NY
National Provider Identifier
1780955377
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- 302731-1
- Practice address
- 56 Gibson Rd.
Goshen, NY 10924 - Phone
- (845) 291-0932
- NPI assigned
- Jan 13, 2012
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 302731-1 | NY | Primary |
Addresses
Primary practice location
56 Gibson Rd.
Goshen, NY 10924
Mailing address
806 Union Corners Rd
Florida, NY 10921-3104
Phone (845) 651-1588
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 302731-1 | NY | MD | Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1326412800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1326412800000",
"number": "1780955377",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "806 UNION CORNERS RD",
"city": "FLORIDA",
"state": "NY",
"postal_code": "109213104",
"telephone_number": "845-651-1588"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "56 GIBSON RD.",
"city": "GOSHEN",
"state": "NY",
"postal_code": "10924",
"telephone_number": "845-291-0932"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WALCZAK",
"first_name": "KAREN",
"middle_name": "ANN",
"credential": "NURSE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-01-13",
"last_updated": "2012-01-13",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "NY",
"license": "302731-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Goshen, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.