Healthcare Provider Details

I. General information

NPI: 1306883020
Provider Name (Legal Business Name): KAREN B PASIEKA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/01/2006
Last Update Date: 06/06/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

MT. KISCO MEDICAL GROUP, PC 90 SOUTH BEDFORD ROAD
MT. KISCO NY
10549-3412
US

IV. Provider business mailing address

MT. KISCO MEDICAL GROUP, PC 90 SOUTH BEDFORD ROAD
MT. KISCO NY
10549-3412
US

V. Phone/Fax

Practice location:
  • Phone: 914-241-1050
  • Fax: 914-242-1391
Mailing address:
  • Phone: 914-241-1050
  • Fax: 914-242-1391

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number199611
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: