Healthcare Provider Details

I. General information

NPI: 1285122317
Provider Name (Legal Business Name): CAROLINE HOPE BJORKMAN DO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/24/2018
Last Update Date: 08/09/2022
Certification Date: 08/09/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

248 W 108TH ST
NEW YORK NY
10025-2956
US

IV. Provider business mailing address

248 W 108TH ST
NEW YORK NY
10025-2956
US

V. Phone/Fax

Practice location:
  • Phone: 212-636-3375
  • Fax:
Mailing address:
  • Phone: 212-636-3375
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number306639
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: