Provider Demographics
NPI:1144642513
Name:CHAMBERLAIN, KAREN I (L,P,N,)
Entity type:Individual
Prefix:MRS
First Name:KAREN
Middle Name:
Last Name:CHAMBERLAIN
Suffix:I
Gender:F
Credentials:L,P,N,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:49 MORICHES MIDDLE ISLAND RD
Mailing Address - Street 2:
Mailing Address - City:SHIRLEY
Mailing Address - State:NY
Mailing Address - Zip Code:11967-1565
Mailing Address - Country:US
Mailing Address - Phone:631-345-2148
Mailing Address - Fax:631-345-2148
Practice Address - Street 1:49 MORICHES MIDDLE ISLAND RD
Practice Address - Street 2:
Practice Address - City:SHIRLEY
Practice Address - State:NY
Practice Address - Zip Code:11967-1565
Practice Address - Country:US
Practice Address - Phone:631-345-2148
Practice Address - Fax:631-345-2148
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-20
Last Update Date:2014-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY218153-1164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse