Healthcare Provider Details
I. General information
NPI: 1699271023
Provider Name (Legal Business Name): KAREN HSU HOOPER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 04/04/2018
Last Update Date: 09/20/2021
Certification Date: 09/20/2021
Deactivation Date:
Reactivation Date:
III. Provider practice location address
400 E MAIN ST
MOUNT KISCO NY
10549-3477
US
IV. Provider business mailing address
400 E MAIN ST
MOUNT KISCO NY
10549-3417
US
V. Phone/Fax
- Phone: 914-666-1049
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208000000X |
| Taxonomy | Pediatrics Physician |
| License Number | 312634 |
| License Number State | NY |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: