Healthcare Provider Details

I. General information

NPI: 1235526641
Provider Name (Legal Business Name): KAREN NEVAREZ
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/23/2015
Last Update Date: 05/07/2024
Certification Date: 05/07/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

246 MONROE AVE
PARAMUS NJ
07652-4728
US

IV. Provider business mailing address

246 MONROE AVE
PARAMUS NJ
07652-4728
US

V. Phone/Fax

Practice location:
  • Phone: 201-390-8541
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number12196
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number46TR01180600
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: