Provider Demographics
NPI:1407874423
Name:MEDINA, KAREEN (AUD)
Entity Type:Individual
Prefix:DR
First Name:KAREEN
Middle Name:
Last Name:MEDINA
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:DR
Other - First Name:KAREEN
Other - Middle Name:
Other - Last Name:HALPER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:AUD
Mailing Address - Street 1:2501 COTTONTAIL LN
Mailing Address - Street 2:
Mailing Address - City:SOMERSET
Mailing Address - State:NJ
Mailing Address - Zip Code:08873-5125
Mailing Address - Country:US
Mailing Address - Phone:732-529-7120
Mailing Address - Fax:
Practice Address - Street 1:4 PROGRESS ST
Practice Address - Street 2:
Practice Address - City:EDISON
Practice Address - State:NJ
Practice Address - Zip Code:08820-1199
Practice Address - Country:US
Practice Address - Phone:908-222-1845
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-17
Last Update Date:2019-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ41YA00068700231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0071421Medicaid
NYA400011158Medicare PIN
NJ100085Q6XMedicare PIN