Karen Marie Fields, PTA

Individual provider Active NPI Physical Therapy Assistant · Wading River, NY

NPI 1477835775 · NPPES record last updated Sep 13, 2011

Key facts

NPI
1477835775
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapy Assistant 225200000X
License
001032-1 (NY)
Practice address
192 Deer Run
Wading River, NY 11792-1701
Phone
(631) 886-1454
NPI assigned
Sep 13, 2011
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
001032-1NYMDAthletic Trainer

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 001032-1 NY Yes

Addresses

Primary practice location

192 Deer Run
Wading River, NY 11792-1701

Mailing address

192 Deer Run
Wading River, NY 11792-1701
Phone (631) 886-1454

Other providers in Wading River, NY

All providers in Wading River, NY · Physical Therapy Assistant in New York

Sources for this page

Verify at the official NPI Registry.