Provider Demographics
NPI:1255662375
Name:KARL, SUSAN M (PHYSICAL THERAPIST)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:M
Last Name:KARL
Suffix:
Gender:F
Credentials:PHYSICAL THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:263 ROSEWOOD LN
Mailing Address - Street 2:
Mailing Address - City:PORT READING
Mailing Address - State:NJ
Mailing Address - Zip Code:07064-1240
Mailing Address - Country:US
Mailing Address - Phone:732-213-3372
Mailing Address - Fax:
Practice Address - Street 1:32 LAUREL AVE
Practice Address - Street 2:
Practice Address - City:KEANSBURG
Practice Address - State:NJ
Practice Address - Zip Code:07734-1125
Practice Address - Country:US
Practice Address - Phone:732-787-8100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-01-29
Last Update Date:2013-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA00556100225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist