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General NPI Number Information
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NPI Number | 1811183593
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Entity Type | Individual
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Provider Name | KAREN MCGINNIS PSYD; RPT
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Gender | Female
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Dates
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Enumeration Date | 09/17/2007
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Last Update Date | 09/17/2007
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Provider Practice Location Address
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Address Line | 978 ROUTE 45 NORTHSIDE PLAZA, SUITE 200
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City | POMONA
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State | NY
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Zip | 10970-3521
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Country | US
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Telephone | 551-206-8040
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Fax |
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Provider Business Mailing Address
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Address Line | 39-07 TAYLOR RD
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City | FAIR LAWN
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State | NJ
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Zip | 07410-5137
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Country | US
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Telephone | 551-206-8040
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Fax | 201-791-8029
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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 | 103TC2200X
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Taxonomy Name | Clinical Child & Adolescent Psychologist
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License Number | 016884
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License Number State | NY
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