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General NPI Number Information
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NPI Number | 1669572103
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Entity Type | Individual
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Provider Name | MS. KAREN CANELLOS
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Gender | Female
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Dates
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Enumeration Date | 09/24/2006
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Last Update Date | 12/06/2007
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Provider Practice Location Address
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Address Line | 347 ELISA DR
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City | ENGLEWOOD CLIFFS
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State | NJ
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Zip | 07632-1721
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Country | US
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Telephone | 201-661-0811
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Fax |
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Provider Business Mailing Address
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Address Line | 1111 RIVER RD APT H5
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City | EDGEWATER
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State | NJ
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Zip | 07020-1370
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Country | US
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Telephone | 201-390-4070
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Fax | 201-569-3042
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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 | 40QA00665800
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License Number State | NJ
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