Healthcare Provider Details

I. General information

NPI: 1902722853
Provider Name (Legal Business Name): KAREN PINO PTA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/25/2026
Last Update Date: 06/25/2026
Certification Date: 06/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2133 RALPH AVE
BROOKLYN NY
11234-5405
US

IV. Provider business mailing address

5473 PRINCETON DR
SANTA MARIA CA
93455-5555
US

V. Phone/Fax

Practice location:
  • Phone: 718-451-1400
  • Fax:
Mailing address:
  • Phone: 805-868-7348
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number014724
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: