Provider Demographics
NPI:1851410310
Name:GOLDBERG, KAREN E (PT)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:E
Last Name:GOLDBERG
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:KAREN
Other - Middle Name:E
Other - Last Name:SMITH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:775 LAFAYETTE RD STE 9
Mailing Address - Street 2:
Mailing Address - City:PORTSMOUTH
Mailing Address - State:NH
Mailing Address - Zip Code:03801-5434
Mailing Address - Country:US
Mailing Address - Phone:603-431-9700
Mailing Address - Fax:603-431-9701
Practice Address - Street 1:775 LAFAYETTE RD STE 9
Practice Address - Street 2:
Practice Address - City:PORTSMOUTH
Practice Address - State:NH
Practice Address - Zip Code:03801-5434
Practice Address - Country:US
Practice Address - Phone:603-431-9700
Practice Address - Fax:603-431-9701
Is Sole Proprietor?:No
Enumeration Date:2007-03-28
Last Update Date:2024-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH2935225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH3078053Medicaid
NHPENDINGMedicare ID - Type Unspecified