Healthcare Provider Details

I. General information

NPI: 1720134950
Provider Name (Legal Business Name): LITTLE FERRY SPORTS AND REHAB
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/29/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

167 WASHINGTON AVE
LITTLE FERRY NJ
07643-2009
US

IV. Provider business mailing address

167 WASHINGTON AVE
LITTLE FERRY NJ
07643-2009
US

V. Phone/Fax

Practice location:
  • Phone: 201-641-1600
  • Fax: 201-807-0231
Mailing address:
  • Phone: 201-641-1600
  • Fax: 201-807-0231

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberMC02495
License Number StateNJ
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name: DR. KAREN M WALTERS
Title or Position: OWNER AND CHIROPRACTOR
Credential: DC
Phone: 201-641-1600