Provider Demographics
NPI:1740536556
Name:JORDAN, KAREN M (TSHH)
Entity type:Individual
Prefix:MS
First Name:KAREN
Middle Name:M
Last Name:JORDAN
Suffix:
Gender:F
Credentials:TSHH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 KNOLLS CRES
Mailing Address - Street 2:APT. 8D
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10463-6336
Mailing Address - Country:US
Mailing Address - Phone:347-275-3813
Mailing Address - Fax:
Practice Address - Street 1:25 KNOLLS CRES
Practice Address - Street 2:APT. 8D
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10463-6336
Practice Address - Country:US
Practice Address - Phone:347-275-3813
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-30
Last Update Date:2012-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist