Provider Demographics
NPI:1548552185
Name:FLIEGELMAN, KAREN GAIL (OD)
Entity type:Individual
Prefix:DR
First Name:KAREN
Middle Name:GAIL
Last Name:FLIEGELMAN
Suffix:
Gender:F
Credentials:OD
Other - Prefix:MRS
Other - First Name:KAREN
Other - Middle Name:
Other - Last Name:LEFKOWITZ
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:207 VAN HOUTEN AVE
Mailing Address - Street 2:
Mailing Address - City:PASSAIC
Mailing Address - State:NJ
Mailing Address - Zip Code:07055-4606
Mailing Address - Country:US
Mailing Address - Phone:973-815-9989
Mailing Address - Fax:
Practice Address - Street 1:1823 AVENUE M
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11230-5308
Practice Address - Country:US
Practice Address - Phone:718-377-5649
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-13
Last Update Date:2011-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYTUV005948-1152W00000X
NJ27OA00564800152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist