Provider Demographics
NPI:1912045048
Name:KARN, REGINA JOSEPHINE
Entity Type:Individual
Prefix:MRS
First Name:REGINA
Middle Name:JOSEPHINE
Last Name:KARN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:325 ASHAROKEN AVE
Mailing Address - Street 2:
Mailing Address - City:NORTHPORT
Mailing Address - State:NY
Mailing Address - Zip Code:11768-1168
Mailing Address - Country:US
Mailing Address - Phone:631-754-2256
Mailing Address - Fax:
Practice Address - Street 1:325 ASHAROKEN AVE
Practice Address - Street 2:
Practice Address - City:NORTHPORT
Practice Address - State:NY
Practice Address - Zip Code:11768-1168
Practice Address - Country:US
Practice Address - Phone:631-574-2256
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY004338-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist