Provider Demographics
NPI:1932483070
Name:MENNELLA, KAREN MARIE (DC)
Entity Type:Individual
Prefix:DR
First Name:KAREN
Middle Name:MARIE
Last Name:MENNELLA
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 1:220 HAMBURG TPKE STE 14A
Mailing Address - Street 2:
Mailing Address - City:WAYNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07470-2132
Mailing Address - Country:US
Mailing Address - Phone:862-336-1600
Mailing Address - Fax:862-336-1601
Practice Address - Street 1:220 HAMBURG TPKE STE 14A
Practice Address - Street 2:
Practice Address - City:WAYNE
Practice Address - State:NJ
Practice Address - Zip Code:07470-2132
Practice Address - Country:US
Practice Address - Phone:862-336-1600
Practice Address - Fax:862-336-1601
Is Sole Proprietor?:No
Enumeration Date:2011-10-07
Last Update Date:2021-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00372700111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor