Karen Barraca

Individual provider Active NPI Physical Therapist · Hawthorne, CA

NPI 1104580901 · NPPES record last updated Oct 27, 2021

Key facts

NPI
1104580901
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapist 225100000X
License
045771 (NY)
Practice address
4900 W 116TH St Apt 22
Hawthorne, CA 90250-2051
Phone
(310) 848-7244
NPI assigned
Oct 27, 2021
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
045771NYMDPhysical Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 045771 NY Yes

Addresses

Primary practice location

4900 W 116TH St Apt 22
Hawthorne, CA 90250-2051

Mailing address

4900 W 116TH St Apt 22
Hawthorne, CA 90250-2051
Phone (310) 848-7244

Other providers in Hawthorne, CA

All providers in Hawthorne, CA · Physical Therapist in California

Sources for this page

Verify at the official NPI Registry.