Healthcare Provider Details

I. General information

NPI: 1396875621
Provider Name (Legal Business Name): KAREN TIZER M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/06/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

451 CLARKSON AVE
BROOKLYN NY
11203-2057
US

IV. Provider business mailing address

505 E 79TH ST APT 3M
NEW YORK NY
10021-0709
US

V. Phone/Fax

Practice location:
  • Phone: 718-245-4105
  • Fax:
Mailing address:
  • Phone: 212-737-4423
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0208X
TaxonomyPediatric Infectious Diseases Physician
License Number194172
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: