Provider Demographics
NPI:1821523408
Name:CARNEY, KAREN ANNE
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:ANNE
Last Name:CARNEY
Suffix:
Gender:F
Credentials:
Other - Prefix:MISS
Other - First Name:KAREN
Other - Middle Name:ANNE
Other - Last Name:LYONS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:14 RESEARCH WAY
Mailing Address - Street 2:
Mailing Address - City:EAST SETAUKET
Mailing Address - State:NY
Mailing Address - Zip Code:11733-3453
Mailing Address - Country:US
Mailing Address - Phone:631-331-6400
Mailing Address - Fax:631-331-6865
Practice Address - Street 1:14 RESEARCH WAY
Practice Address - Street 2:
Practice Address - City:EAST SETAUKET
Practice Address - State:NY
Practice Address - Zip Code:11733-3453
Practice Address - Country:US
Practice Address - Phone:631-331-6400
Practice Address - Fax:631-331-6865
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-20
Last Update Date:2017-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY886449141174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist