Provider Demographics
NPI:1437466836
Name:SROCZYNSKI, KAREN A (PTA)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:A
Last Name:SROCZYNSKI
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:KAREN
Other - Middle Name:A
Other - Last Name:DAMBERG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:41 WERNER RD
Mailing Address - Street 2:
Mailing Address - City:CLIFTON PARK
Mailing Address - State:NY
Mailing Address - Zip Code:12065-3409
Mailing Address - Country:US
Mailing Address - Phone:518-664-5066
Mailing Address - Fax:
Practice Address - Street 1:41 WERNER RD
Practice Address - Street 2:
Practice Address - City:CLIFTON PARK
Practice Address - State:NY
Practice Address - Zip Code:12065-3409
Practice Address - Country:US
Practice Address - Phone:518-664-5066
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-09-07
Last Update Date:2010-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000049-1225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant