Provider Demographics
NPI:1700254885
Name:ABRUZZO, KAREN
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:
Last Name:ABRUZZO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 ASHLAND PL
Mailing Address - Street 2:
Mailing Address - City:EAST NORTHPORT
Mailing Address - State:NY
Mailing Address - Zip Code:11731-1902
Mailing Address - Country:US
Mailing Address - Phone:631-261-9883
Mailing Address - Fax:631-499-4383
Practice Address - Street 1:10 ASHLAND PL
Practice Address - Street 2:
Practice Address - City:EAST NORTHPORT
Practice Address - State:NY
Practice Address - Zip Code:11731-1902
Practice Address - Country:US
Practice Address - Phone:631-261-9883
Practice Address - Fax:631-499-4383
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-08
Last Update Date:2015-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY879620171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator