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General NPI Number Information
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NPI Number | 1366567182
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Entity Type | Individual
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Provider Name | KAREN ANN LITTLE M.S.P.T.
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Gender | Female
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Dates
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Enumeration Date | 03/20/2007
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Last Update Date | 10/03/2008
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Provider Practice Location Address
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Address Line | 160 E MAIN ST
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City | PORT JERVIS
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State | NY
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Zip | 12771-2114
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Country | US
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Telephone | 845-858-7000
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Fax |
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Provider Business Mailing Address
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Address Line | 108 OLD CAHOONZIE ROAD
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City | SPARROW BUSH
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State | NY
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Zip | 12780-5556
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Country | US
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Telephone | 845-858-7000
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 13401-1
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT019472
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License Number State | PA
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