Healthcare Provider Details

I. General information

NPI: 1700078334
Provider Name (Legal Business Name): KAREN PETERS CONNOLLY OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/17/2007
Last Update Date: 08/17/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

520 GREENBRIAR RD
YORK PA
17404-1335
US

IV. Provider business mailing address

520 GREENBRIAR RD
YORK PA
17404-1335
US

V. Phone/Fax

Practice location:
  • Phone: 717-849-5547
  • Fax: 767-767-6716
Mailing address:
  • Phone: 717-849-5547
  • Fax: 767-767-6716

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberOC003357L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: