MEDICARE: OLIVIA JULIA KARCZEWSKI PA-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363A00000X	Physician Assistant	025588	NY
2	363AM0700X	Medical Physician Assistant	25MP00851000	NJ

General Provider Information

NPI Number	:	1487269015
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	OLIVIA JULIA KARCZEWSKI PA-C

Provider Business Mailing Address
First Line	:	7764 76TH ST
Second Line	:
City	:	GLENDALE
State	:	NY
Zip	:	11385-8239
Country	:	US
Telephone Number	:	347-907-2430
Fax Number	:

Provider Business Practice Location Address
First Line	:	1425 BLOOMFIELD ST
Second Line	:
City	:	HOBOKEN
State	:	NJ
Zip	:	07030-5505
Country	:	US
Telephone Number	:	201-706-8490
Fax Number	:	201-285-6514

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/10/2020
Last Update Date	:	01/15/2025

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