MEDICARE: MRS. KAREN E MINUNNO M ED

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	171M00000X	Case Manager/Care Coordinator

General Provider Information

NPI Number	:	1851777023
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. KAREN E MINUNNO M ED

Provider Business Mailing Address
First Line	:	533 MONTAUK HWY
Second Line	:
City	:	WESTHAMPTON BEACH
State	:	NY
Zip	:	11978-1802
Country	:	US
Telephone Number	:	631-680-9060
Fax Number	:	631-288-4659

Provider Business Practice Location Address
First Line	:	533 MONTAUK HWY
Second Line	:
City	:	WESTHAMPTON BEACH
State	:	NY
Zip	:	11978-1802
Country	:	US
Telephone Number	:	631-680-9060
Fax Number	:	631-288-4659

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/10/2015
Last Update Date	:	08/10/2015

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