Provider Demographics
NPI:1073757159
Name:ROSENFELD, KAREN (PHD, OTR)
Entity Type:Individual
Prefix:DR
First Name:KAREN
Middle Name:
Last Name:ROSENFELD
Suffix:
Gender:F
Credentials:PHD, OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:711 W END AVE APT 5LS
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10025-0042
Mailing Address - Country:US
Mailing Address - Phone:917-232-6154
Mailing Address - Fax:
Practice Address - Street 1:711 W END AVE APT 5LS
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10025-0042
Practice Address - Country:US
Practice Address - Phone:917-232-6154
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-04-21
Last Update Date:2020-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY012595-01225X00000X
NY023487-01103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY012595-01OtherNYS LICENSE