Provider Demographics
NPI:1134499502
Name:KORBUL, KAREN (MS, ATC, CSCS)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:
Last Name:KORBUL
Suffix:
Gender:F
Credentials:MS, ATC, CSCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1445 ROUTE 31
Mailing Address - Street 2:
Mailing Address - City:ANNANDALE
Mailing Address - State:NJ
Mailing Address - Zip Code:08801-3117
Mailing Address - Country:US
Mailing Address - Phone:908-713-4199
Mailing Address - Fax:908-713-4403
Practice Address - Street 1:1445 ROUTE 31
Practice Address - Street 2:
Practice Address - City:ANNANDALE
Practice Address - State:NJ
Practice Address - Zip Code:08801-3117
Practice Address - Country:US
Practice Address - Phone:908-713-4199
Practice Address - Fax:908-713-4403
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-03
Last Update Date:2012-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MT000263002255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer