Healthcare Provider Details

I. General information

NPI: 1871968131
Provider Name (Legal Business Name): MRS. KAREN FAETH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/11/2015
Last Update Date: 12/11/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1606 OLD ORCHARD ROAD
WHITE PLAINS NY
10604
US

IV. Provider business mailing address

2 WITTMANN DR
KATONAH NY
10536-3013
US

V. Phone/Fax

Practice location:
  • Phone: 914-948-7271
  • Fax:
Mailing address:
  • Phone: 914-232-8112
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WS0200X
TaxonomySchool Registered Nurse
License Number360493-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: