=====================================================
General NPI Number Information
=====================================================
NPI Number | 1902910003
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | KAREN FLORENCE DELGADO PT
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/18/2006
-----------------------------------------------------
Last Update Date | 06/09/2014
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 660 TENNENT RD SUITE 107
-----------------------------------------------------
City | MANALAPAN
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 07726-3163
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 732-617-6237
-----------------------------------------------------
Fax | 732-617-6239
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 81 VLIET ST
-----------------------------------------------------
City | SPOTSWOOD
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 08884-1409
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 225100000X
-----------------------------------------------------
Taxonomy Name | Physical Therapist
-----------------------------------------------------
License Number | 40QA00968600
-----------------------------------------------------
License Number State | NJ
-----------------------------------------------------