Provider Demographics
NPI:1801860721
Name:PECK, KAREN YVONNE (ATC)
Entity Type:Individual
Prefix:MRS
First Name:KAREN
Middle Name:YVONNE
Last Name:PECK
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:40 WILSON RD
Mailing Address - Street 2:APT. I
Mailing Address - City:WEST POINT
Mailing Address - State:NY
Mailing Address - Zip Code:10996-1919
Mailing Address - Country:US
Mailing Address - Phone:845-527-6463
Mailing Address - Fax:
Practice Address - Street 1:727 BREWERTON RD
Practice Address - Street 2:DEPARTMENT OF PHYSICAL EDUCATION
Practice Address - City:WEST POINT
Practice Address - State:NY
Practice Address - Zip Code:10996-1602
Practice Address - Country:US
Practice Address - Phone:845-938-2352
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer