Provider Demographics
NPI:1871815704
Name:KINGMAN, KAROLYN RUTH (MS, OTR)
Entity Type:Individual
Prefix:
First Name:KAROLYN
Middle Name:RUTH
Last Name:KINGMAN
Suffix:
Gender:F
Credentials:MS, OTR
Other - Prefix:
Other - First Name:KAROLYN
Other - Middle Name:KINGMAN
Other - Last Name:SROKA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 72
Mailing Address - Street 2:
Mailing Address - City:CROTON ON HUDSON
Mailing Address - State:NY
Mailing Address - Zip Code:10520-0072
Mailing Address - Country:US
Mailing Address - Phone:914-703-2353
Mailing Address - Fax:
Practice Address - Street 1:272 N BEDFORD RD
Practice Address - Street 2:
Practice Address - City:MOUNT KISCO
Practice Address - State:NY
Practice Address - Zip Code:10549-1103
Practice Address - Country:US
Practice Address - Phone:914-703-2353
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-19
Last Update Date:2010-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY015191225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist