Provider Demographics
NPI:1023575792
Name:GREELEY, KAREN SUZANNE (PT)
Entity Type:Individual
Prefix:DR
First Name:KAREN
Middle Name:SUZANNE
Last Name:GREELEY
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 SCOTTS MANOR CT
Mailing Address - Street 2:
Mailing Address - City:FREELAND
Mailing Address - State:MD
Mailing Address - Zip Code:21053-9400
Mailing Address - Country:US
Mailing Address - Phone:410-274-6230
Mailing Address - Fax:410-882-4321
Practice Address - Street 1:10 SCOTTS MANOR CT
Practice Address - Street 2:
Practice Address - City:FREELAND
Practice Address - State:MD
Practice Address - Zip Code:21053-9400
Practice Address - Country:US
Practice Address - Phone:410-274-6230
Practice Address - Fax:410-882-4321
Is Sole Proprietor?:No
Enumeration Date:2019-02-28
Last Update Date:2019-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD15498225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist