Provider Demographics
NPI:1447372669
Name:PURCELL, KAREN (MAPT)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:
Last Name:PURCELL
Suffix:
Gender:F
Credentials:MAPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:467 NEW YORK AVE
Mailing Address - Street 2:467 NEW YORK AVENUE
Mailing Address - City:HUNTINGTON
Mailing Address - State:NY
Mailing Address - Zip Code:11743-3441
Mailing Address - Country:US
Mailing Address - Phone:631-424-1100
Mailing Address - Fax:631-424-1105
Practice Address - Street 1:467 NEW YORK AVE
Practice Address - Street 2:
Practice Address - City:HUNTINGTON
Practice Address - State:NY
Practice Address - Zip Code:11743-3441
Practice Address - Country:US
Practice Address - Phone:631-424-1100
Practice Address - Fax:631-424-1105
Is Sole Proprietor?:No
Enumeration Date:2007-04-06
Last Update Date:2008-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY7489208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYQ54061Medicare ID - Type Unspecified