Healthcare Provider Details

I. General information

NPI: 1386170991
Provider Name (Legal Business Name): KAREN MCCARTHY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KAREN KOVACK

II. Dates (important events)

Enumeration Date: 05/03/2017
Last Update Date: 07/12/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2531 ROUTE 52 SUITE 2
HOPEWELL JUNCTION NY
12533
US

IV. Provider business mailing address

16 MAYBROOK RD SUITE K
CAMPBELL HALL NY
10916-2743
US

V. Phone/Fax

Practice location:
  • Phone: 845-592-4747
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number040918
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: