Provider Demographics
NPI:1992834170
Name:BELENO CARNEY, KARINA (LIC AC)
Entity Type:Individual
Prefix:
First Name:KARINA
Middle Name:
Last Name:BELENO CARNEY
Suffix:
Gender:F
Credentials:LIC AC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 992
Mailing Address - Street 2:
Mailing Address - City:GROTON
Mailing Address - State:MA
Mailing Address - Zip Code:01450-0992
Mailing Address - Country:US
Mailing Address - Phone:978-294-9291
Mailing Address - Fax:
Practice Address - Street 1:78A MAIN ST
Practice Address - Street 2:
Practice Address - City:PEPPERELL
Practice Address - State:MA
Practice Address - Zip Code:01463-1561
Practice Address - Country:US
Practice Address - Phone:978-294-9291
Practice Address - Fax:978-294-9291
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-05
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA226478171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist