Provider Demographics
NPI:1699186221
Name:FRAGA, KAREN
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:
Last Name:FRAGA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:159 BULLET HOLE RD
Mailing Address - Street 2:
Mailing Address - City:MAHOPAC
Mailing Address - State:NY
Mailing Address - Zip Code:10541-2515
Mailing Address - Country:US
Mailing Address - Phone:914-560-6121
Mailing Address - Fax:
Practice Address - Street 1:159 BULLET HOLE RD
Practice Address - Street 2:
Practice Address - City:MAHOPAC
Practice Address - State:NY
Practice Address - Zip Code:10541-2515
Practice Address - Country:US
Practice Address - Phone:914-560-6121
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-16
Last Update Date:2021-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist