Provider Demographics
NPI:1295866929
Name:SYBERTZ, KAREN
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:
Last Name:SYBERTZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:304 HARVARD ST
Mailing Address - Street 2:
Mailing Address - City:E BRIDGEWATER
Mailing Address - State:MA
Mailing Address - Zip Code:02333-1112
Mailing Address - Country:US
Mailing Address - Phone:508-690-1404
Mailing Address - Fax:508-583-4649
Practice Address - Street 1:63 MAIN ST
Practice Address - Street 2:
Practice Address - City:BROCKTON
Practice Address - State:MA
Practice Address - Zip Code:02301-4012
Practice Address - Country:US
Practice Address - Phone:508-559-6699
Practice Address - Fax:508-583-4649
Is Sole Proprietor?:No
Enumeration Date:2007-03-07
Last Update Date:2008-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, Education