Healthcare Provider Details

I. General information

NPI: 1891727152
Provider Name (Legal Business Name): KAREN S ABLOW DMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/07/2006
Last Update Date: 03/30/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

145 DURHAM ROAD
MADISON CT
06443
US

IV. Provider business mailing address

145 DURHAM ROAD
MADISON CT
06443
US

V. Phone/Fax

Practice location:
  • Phone: 203-245-7926
  • Fax: 203-245-8024
Mailing address:
  • Phone: 203-245-7926
  • Fax: 203-245-8024

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License Number007442
License Number StateCT
# 2
Primary TaxonomyN
Taxonomy Code204E00000X
TaxonomyOral & Maxillofacial Surgery (D.M.D.)
License Number007442
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: