Provider Demographics
NPI:1134118151
Name:STANLEY WHITE, KAREN M (BS PT)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:M
Last Name:STANLEY WHITE
Suffix:
Gender:F
Credentials:BS PT
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:1 NEW HAMPSHIRE AVE
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:NY
Mailing Address - Zip Code:12180-1754
Mailing Address - Country:US
Mailing Address - Phone:578-273-2121
Mailing Address - Fax:578-273-0701
Practice Address - Street 1:1 NEW HAMPSHIRE AVE
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:NY
Practice Address - Zip Code:12180-1754
Practice Address - Country:US
Practice Address - Phone:578-273-2121
Practice Address - Fax:578-273-0701
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-21
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY0145781225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
P35607Medicare UPIN
NYRA6654Medicare ID - Type Unspecified