Healthcare Provider Details

I. General information

NPI: 1124218201
Provider Name (Legal Business Name): KRISTIN KARNAY LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/26/2007
Last Update Date: 08/16/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

98120 QUEENS BLVD SUITE 9
REGO PARK NY
11374-4357
US

IV. Provider business mailing address

46 VIRGINIA RD
BABYLON NY
11702-3922
US

V. Phone/Fax

Practice location:
  • Phone: 718-830-0246
  • Fax:
Mailing address:
  • Phone: 631-835-8148
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number073528
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: