Provider Demographics
NPI:1265517882
Name:WALTERS, KAREN (DC)
Entity type:Individual
Prefix:DR
First Name:KAREN
Middle Name:
Last Name:WALTERS
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 1:114 BUCKHAVEN HL
Mailing Address - Street 2:
Mailing Address - City:UPPER SADDLE RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:07458-1711
Mailing Address - Country:US
Mailing Address - Phone:201-934-5844
Mailing Address - Fax:201-934-4059
Practice Address - Street 1:167 WASHINGTON AVE
Practice Address - Street 2:
Practice Address - City:LITTLE FERRY
Practice Address - State:NJ
Practice Address - Zip Code:07643-2009
Practice Address - Country:US
Practice Address - Phone:201-641-1600
Practice Address - Fax:201-807-0231
Is Sole Proprietor?:No
Enumeration Date:2006-10-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00249500111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJT44681Medicare UPIN
NJ087239Q98Medicare ID - Type Unspecified