Healthcare Provider Details

I. General information

NPI: 1992908198
Provider Name (Legal Business Name): KARI ALICIA WHITLEY M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/06/2007
Last Update Date: 12/09/2022
Certification Date: 12/09/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

525 E 68TH ST STE J-130
NEW YORK NY
10065-4870
US

IV. Provider business mailing address

525 E 68TH ST STE J-130
NEW YORK NY
10065-4870
US

V. Phone/Fax

Practice location:
  • Phone: 212-746-3676
  • Fax:
Mailing address:
  • Phone: 212-746-3676
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberMD446046
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code207VM0101X
TaxonomyMaternal & Fetal Medicine Physician
License NumberMD446046
License Number StatePA
# 3
Primary TaxonomyY
Taxonomy Code207VM0101X
TaxonomyMaternal & Fetal Medicine Physician
License Number319469
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: