Healthcare Provider Details

I. General information

NPI: 1790028546
Provider Name (Legal Business Name): KENNETH JAY KARAS H.I.S
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/30/2013
Last Update Date: 09/02/2021
Certification Date: 09/02/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3520 POST RD
WARWICK RI
02886-7140
US

IV. Provider business mailing address

3520 POST RD
WARWICK RI
02886-7140
US

V. Phone/Fax

Practice location:
  • Phone: 401-921-0181
  • Fax:
Mailing address:
  • Phone: 401-921-0181
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License Number264
License Number StateRI
# 2
Primary TaxonomyN
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License Number35
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: