Healthcare Provider Details

I. General information

NPI: 1609155308
Provider Name (Legal Business Name): KAREN H BRODY, MD, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/11/2011
Last Update Date: 08/11/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22 5TH ST
STAMFORD CT
06905-5030
US

IV. Provider business mailing address

22 5TH ST
STAMFORD CT
06905-5030
US

V. Phone/Fax

Practice location:
  • Phone: 203-359-6777
  • Fax: 203-359-6355
Mailing address:
  • Phone: 203-359-6777
  • Fax: 203-359-6355

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084F0202X
TaxonomyForensic Psychiatry Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. KAREN HOWARD BRODY
Title or Position: OWNER
Credential: MD
Phone: 203-359-6777