Healthcare Provider Details

I. General information

NPI: 1891687307
Provider Name (Legal Business Name): KAREN BLACKMAN MSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/18/2025
Last Update Date: 07/18/2025
Certification Date: 07/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22 APPIAN DR
ROCHESTER NY
14606-4721
US

IV. Provider business mailing address

11 WATCHMAN CT
ROCHESTER NY
14624-4930
US

V. Phone/Fax

Practice location:
  • Phone: 585-230-1759
  • Fax:
Mailing address:
  • Phone: 585-230-7259
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: