Provider Demographics
NPI:1700282563
Name:NASSER, KARIE (MS, BS, AA)
Entity Type:Individual
Prefix:
First Name:KARIE
Middle Name:
Last Name:NASSER
Suffix:
Gender:F
Credentials:MS, BS, AA
Other - Prefix:
Other - First Name:KARIE
Other - Middle Name:
Other - Last Name:AHO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:9 COMMERCE STREET
Mailing Address - Street 2:
Mailing Address - City:SCOTIA
Mailing Address - State:NY
Mailing Address - Zip Code:12302-2903
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:201 W. MADISON AVENUE
Practice Address - Street 2:
Practice Address - City:JOHNSTOWN
Practice Address - State:NY
Practice Address - Zip Code:12095
Practice Address - Country:US
Practice Address - Phone:518-762-4546
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-11-06
Last Update Date:2014-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY011696-1225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist