Healthcare Provider Details

I. General information

NPI: 1699747154
Provider Name (Legal Business Name): KAREN JOYCE GORAYEB RPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/07/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 HAMPTON RD 205
EXETER NH
03833-4848
US

IV. Provider business mailing address

3 SAINT CYR DR
HAMPTON NH
03842-1163
US

V. Phone/Fax

Practice location:
  • Phone: 603-772-0604
  • Fax:
Mailing address:
  • Phone: 603-926-9849
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License Number1127
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: