=====================================================
General NPI Number Information
=====================================================
NPI Number | 1336723121
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | KARINA PEARSE-LAMALFA
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/08/2021
-----------------------------------------------------
Last Update Date | 05/08/2021
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 177 W MILL ROAD
-----------------------------------------------------
City | LONG VALLEY
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 07853
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 908-867-0060
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 26 CLEARBROOK LN
-----------------------------------------------------
City | FLEMINGTON
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 08822-3502
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 908-296-7131
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 171400000X
-----------------------------------------------------
Taxonomy Name | Health & Wellness Coach
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State | NJ
-----------------------------------------------------