Provider Demographics
NPI:1619132909
Name:MACLENNAN, KAREN G (AUD TSHH)
Entity Type:Individual
Prefix:DR
First Name:KAREN
Middle Name:G
Last Name:MACLENNAN
Suffix:
Gender:F
Credentials:AUD TSHH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27 MANOR DRIVE
Mailing Address - Street 2:
Mailing Address - City:MILLER PLACE
Mailing Address - State:NY
Mailing Address - Zip Code:11764-1324
Mailing Address - Country:US
Mailing Address - Phone:516-353-0066
Mailing Address - Fax:
Practice Address - Street 1:27 MANOR DRIVE
Practice Address - Street 2:
Practice Address - City:MILLER PLACE
Practice Address - State:NY
Practice Address - Zip Code:11764-1324
Practice Address - Country:US
Practice Address - Phone:516-353-0066
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-07-25
Last Update Date:2008-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0015671231H00000X
NY14000009506237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
No237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist