Provider Demographics
NPI:1124375621
Name:CHAMBERLAIN, CAREN M (ATC)
Entity Type:Individual
Prefix:
First Name:CAREN
Middle Name:M
Last Name:CHAMBERLAIN
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:134 FOREST GLEN DRIVE
Mailing Address - Street 2:
Mailing Address - City:HIGHLAND PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:08904
Mailing Address - Country:US
Mailing Address - Phone:848-248-6645
Mailing Address - Fax:
Practice Address - Street 1:134 FOREST GLEN DR
Practice Address - Street 2:
Practice Address - City:HIGHLAND PARK
Practice Address - State:NJ
Practice Address - Zip Code:08904-1938
Practice Address - Country:US
Practice Address - Phone:848-248-6645
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-08-14
Last Update Date:2012-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program