Provider Demographics
NPI:1689850661
Name:ABDUL-KARIM, KENNETH (PHD)
Entity Type:Individual
Prefix:DR
First Name:KENNETH
Middle Name:
Last Name:ABDUL-KARIM
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:74 WESTCLIFF DR
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02360-1476
Mailing Address - Country:US
Mailing Address - Phone:508-560-8832
Mailing Address - Fax:
Practice Address - Street 1:400 NATHAN ELLIS HWY
Practice Address - Street 2:SUITE 1
Practice Address - City:MASHPEE
Practice Address - State:MA
Practice Address - Zip Code:02649-3143
Practice Address - Country:US
Practice Address - Phone:508-477-5488
Practice Address - Fax:508-477-9334
Is Sole Proprietor?:No
Enumeration Date:2008-01-21
Last Update Date:2008-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA8562103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical