Healthcare Provider Details

I. General information

NPI: 1801607981
Provider Name (Legal Business Name): KARA JADE ZWART RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/16/2025
Last Update Date: 01/16/2025
Certification Date: 01/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

707 E MAIN ST
MIDDLETOWN NY
10940-2650
US

IV. Provider business mailing address

PO BOX 97
BURLINGHAM NY
12722-0097
US

V. Phone/Fax

Practice location:
  • Phone: 845-333-1000
  • Fax:
Mailing address:
  • Phone: 845-645-6024
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number954272
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: