Provider Demographics
NPI:1700871274
Name:DAKE, KAREN M (PT PCS)
Entity Type:Individual
Prefix:MRS
First Name:KAREN
Middle Name:M
Last Name:DAKE
Suffix:
Gender:F
Credentials:PT PCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:901 MARITIME DR
Mailing Address - Street 2:
Mailing Address - City:ALPLAUS
Mailing Address - State:NY
Mailing Address - Zip Code:12008-1016
Mailing Address - Country:US
Mailing Address - Phone:518-930-2871
Mailing Address - Fax:518-930-2799
Practice Address - Street 1:901 MARITIME DR
Practice Address - Street 2:
Practice Address - City:ALPLAUS
Practice Address - State:NY
Practice Address - Zip Code:12008-1016
Practice Address - Country:US
Practice Address - Phone:518-930-2871
Practice Address - Fax:518-930-2799
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-12
Last Update Date:2020-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0133652251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics