Provider Demographics
NPI:1710953971
Name:BRIGHAM, KAREN
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:
Last Name:BRIGHAM
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:CORNELL UNIVERSITY HEALTH SERVICES
Mailing Address - Street 2:HO PLAZA
Mailing Address - City:ITHACA
Mailing Address - State:NY
Mailing Address - Zip Code:14853-3101
Mailing Address - Country:US
Mailing Address - Phone:607-255-6946
Mailing Address - Fax:607-254-3503
Practice Address - Street 1:CORNELL UNIVERSITY HEALTH SERVICES
Practice Address - Street 2:HO PLAZA
Practice Address - City:ITHACA
Practice Address - State:NY
Practice Address - Zip Code:14853-3101
Practice Address - Country:US
Practice Address - Phone:607-255-6946
Practice Address - Fax:607-254-3503
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY006079-1225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant