Provider Demographics
NPI:1700958741
Name:RAFFERTY, KAREN A (PHYSICAL THERAPIST)
Entity type:Individual
Prefix:MS
First Name:KAREN
Middle Name:A
Last Name:RAFFERTY
Suffix:
Gender:F
Credentials:PHYSICAL THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 TIGERS CT
Mailing Address - Street 2:
Mailing Address - City:DAUFUSKIE ISLAND
Mailing Address - State:SC
Mailing Address - Zip Code:29915-9308
Mailing Address - Country:US
Mailing Address - Phone:516-547-1905
Mailing Address - Fax:
Practice Address - Street 1:3 TIGERS CT
Practice Address - Street 2:
Practice Address - City:DAUFUSKIE ISLAND
Practice Address - State:SC
Practice Address - Zip Code:29915-9308
Practice Address - Country:US
Practice Address - Phone:516-547-1905
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-14
Last Update Date:2025-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC8095225100000X
NY024144225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYQ30H71Medicare Oscar/Certification
NYQ30H71Medicare PIN