Healthcare Provider Details

I. General information

NPI: 1689582694
Provider Name (Legal Business Name): NICOLE MARY KARABAICH PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/31/2026
Last Update Date: 08/31/2026
Certification Date: 08/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

225 EASTVIEW DR
CENTRAL ISLIP NY
11722-4539
US

IV. Provider business mailing address

22 CARROL PL
GREENLAWN NY
11740-2732
US

V. Phone/Fax

Practice location:
  • Phone: 631-665-1600
  • Fax:
Mailing address:
  • Phone: 631-697-6167
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number036425
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: