Healthcare Provider Details

I. General information

NPI: 1447563325
Provider Name (Legal Business Name): KAREN MARIE COBURN N.P.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/20/2010
Last Update Date: 12/14/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

SBUMC HSC T 9 020
STONY BROOK NY
11794-8091
US

IV. Provider business mailing address

SBUMC HSC T 9 020
STONY BROOK NY
11794-8091
US

V. Phone/Fax

Practice location:
  • Phone: 631-444-2024
  • Fax: 631-444-9175
Mailing address:
  • Phone: 631-444-2024
  • Fax: 631-444-9175

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LX0001X
TaxonomyObstetrics & Gynecology Nurse Practitioner
License NumberF360197
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: