Provider Demographics
NPI:1619306669
Name:SAPORITO, KAREN A (PHD)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:A
Last Name:SAPORITO
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:719 CLARK DR
Mailing Address - Street 2:
Mailing Address - City:MULLICA HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08062-1839
Mailing Address - Country:US
Mailing Address - Phone:856-278-6095
Mailing Address - Fax:866-567-5687
Practice Address - Street 1:1420 WALNUT ST
Practice Address - Street 2:SUITE 1206
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19102-4017
Practice Address - Country:US
Practice Address - Phone:856-278-6095
Practice Address - Fax:866-567-5687
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-09
Last Update Date:2014-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS-009168-L103TC0700X
NJ35S100426200103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical