Provider Demographics
NPI:1922197706
Name:CARNELLI, KAREN (DC)
Entity Type:Individual
Prefix:DR
First Name:KAREN
Middle Name:
Last Name:CARNELLI
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:136 RIDGE ROAD
Mailing Address - Street 2:
Mailing Address - City:NORTH ARLINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07031-6039
Mailing Address - Country:US
Mailing Address - Phone:201-991-0800
Mailing Address - Fax:201-955-2625
Practice Address - Street 1:136 RIDGE ROAD
Practice Address - Street 2:
Practice Address - City:NORTH ARLINGTON
Practice Address - State:NJ
Practice Address - Zip Code:07031-6039
Practice Address - Country:US
Practice Address - Phone:201-991-0800
Practice Address - Fax:201-955-2625
Is Sole Proprietor?:No
Enumeration Date:2006-10-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMC00392500111N00000X
NJ26NO07334800163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered111N00000XChiropractic ProvidersChiropractor
Not Answered163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
P413282OtherOXFORD
2054303OtherUNITED HEALTH CARE
2054303OtherUNITED HEALTH CARE
642766C8DMedicare ID - Type Unspecified