MEDICARE: DR. KAREN KAN M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	220214	NY

General Provider Information

NPI Number	:	1194937524
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KAREN KAN M.D.

Provider Business Mailing Address
First Line	:	1996 SARANAC AVE
Second Line	:	STE. 2
City	:	LAKE PLACID
State	:	NY
Zip	:	12946-1140
Country	:	US
Telephone Number	:	518-523-8882
Fax Number	:

Provider Business Practice Location Address
First Line	:	1996 SARANAC AVE
Second Line	:	STE. 2
City	:	LAKE PLACID
State	:	NY
Zip	:	12946-1140
Country	:	US
Telephone Number	:	518-523-8882
Fax Number	:	518-837-5261

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/06/2007
Last Update Date	:	02/24/2015

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