Provider Demographics
NPI:1548367659
Name:JOHNSON-ADAMSON, KAREN L (MD)
Entity type:Individual
Prefix:DR
First Name:KAREN
Middle Name:L
Last Name:JOHNSON-ADAMSON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:470 MALCOLM X BLVD
Mailing Address - Street 2:SUITE 1P
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10037-3003
Mailing Address - Country:US
Mailing Address - Phone:212-862-8722
Mailing Address - Fax:212-862-8599
Practice Address - Street 1:470 MALCOLM X BLVD
Practice Address - Street 2:SUITE 1P
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10037-3003
Practice Address - Country:US
Practice Address - Phone:212-862-8722
Practice Address - Fax:212-862-8599
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2014-02-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY153418207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01571659Medicaid
NY153418A58OtherHEALTHFIRST PROVIDER ID
NYP3602331OtherOXFORD HEALTH PLANS ID
NY01571659Medicaid
NYP3602331OtherOXFORD HEALTH PLANS ID