Provider Demographics
NPI:1922186519
Name:MANFRE', KAREN R (ATHLETIC TRAINER)
Entity Type:Individual
Prefix:MS
First Name:KAREN
Middle Name:R
Last Name:MANFRE'
Suffix:
Gender:F
Credentials:ATHLETIC TRAINER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 RIVERVIEW DR
Mailing Address - Street 2:
Mailing Address - City:WEST TRENTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08628-2618
Mailing Address - Country:US
Mailing Address - Phone:609-538-8941
Mailing Address - Fax:
Practice Address - Street 1:84 STATE ROUTE 31
Practice Address - Street 2:
Practice Address - City:FLEMINGTON
Practice Address - State:NJ
Practice Address - Zip Code:08822-1251
Practice Address - Country:US
Practice Address - Phone:908-284-7131
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MT000172002255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer