Provider Demographics
NPI:1508956731
Name:DESIMONE, KAREN MARIE (DPT)
Entity Type:Individual
Prefix:DR
First Name:KAREN
Middle Name:MARIE
Last Name:DESIMONE
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:23 WHITES PATH STE E
Mailing Address - Street 2:
Mailing Address - City:SOUTH YARMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02664-1239
Mailing Address - Country:US
Mailing Address - Phone:508-619-4833
Mailing Address - Fax:508-619-4835
Practice Address - Street 1:23 WHITES PATH STE E
Practice Address - Street 2:
Practice Address - City:SOUTH YARMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02664-1239
Practice Address - Country:US
Practice Address - Phone:508-619-4833
Practice Address - Fax:508-619-4835
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-16
Last Update Date:2021-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA15542225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist