Healthcare Provider Details

I. General information

NPI: 1922936608
Provider Name (Legal Business Name): MARTIN KARASEWICZ
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/12/2026
Last Update Date: 07/16/2026
Certification Date: 07/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

150 55TH ST
BROOKLYN NY
11220-2508
US

IV. Provider business mailing address

150 55TH ST
BROOKLYN NY
11220-2508
US

V. Phone/Fax

Practice location:
  • Phone: 929-486-0824
  • Fax:
Mailing address:
  • Phone: 929-486-0824
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number312938
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: