Provider Demographics
NPI:1417215864
Name:KAPLAN, CAROLYN CHERYL (PT)
Entity Type:Individual
Prefix:MRS
First Name:CAROLYN
Middle Name:CHERYL
Last Name:KAPLAN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:963 GREENWOOD RD
Mailing Address - Street 2:
Mailing Address - City:TEANECK
Mailing Address - State:NJ
Mailing Address - Zip Code:07666-6630
Mailing Address - Country:US
Mailing Address - Phone:917-449-4187
Mailing Address - Fax:
Practice Address - Street 1:963 GREENWOOD RD
Practice Address - Street 2:
Practice Address - City:TEANECK
Practice Address - State:NJ
Practice Address - Zip Code:07666-6630
Practice Address - Country:US
Practice Address - Phone:917-449-4187
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-23
Last Update Date:2012-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY014632-1174400000X
NJ40QA00637600174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist