Provider Demographics
NPI:1770689994
Name:GIFFING, KAREN BROWN (PT)
Entity Type:Individual
Prefix:MS
First Name:KAREN
Middle Name:BROWN
Last Name:GIFFING
Suffix:
Gender:F
Credentials:PT
Other - Prefix:MS
Other - First Name:KAREN
Other - Middle Name:MARIE
Other - Last Name:BROWN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:39 MOWBRAY LN
Mailing Address - Street 2:
Mailing Address - City:NORTH EAST
Mailing Address - State:MD
Mailing Address - Zip Code:21901-6331
Mailing Address - Country:US
Mailing Address - Phone:410-287-3791
Mailing Address - Fax:
Practice Address - Street 1:18 MONTGOMERY DR
Practice Address - Street 2:SUITE 10
Practice Address - City:NORTH EAST
Practice Address - State:MD
Practice Address - Zip Code:21901-3817
Practice Address - Country:US
Practice Address - Phone:410-287-5057
Practice Address - Fax:410-287-5604
Is Sole Proprietor?:No
Enumeration Date:2006-09-15
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD16540225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD4561995OtherAETNA PROVIDER NUMBER
MD523386OtherMAMSI PROVIDER #
MDH671OtherCAREFIRST BC PROVIDER #
MDS9520015OtherBC FEDERAL
MD216555Medicare ID - Type UnspecifiedPROVIDER NUMBER