Provider Demographics
NPI:1831400662
Name:GUARDIOLA, KAREN
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:
Last Name:GUARDIOLA
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 1:500 E 83RD ST APT 14J
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10028-7397
Mailing Address - Country:US
Mailing Address - Phone:212-288-4191
Mailing Address - Fax:
Practice Address - Street 1:500 E 83RD ST APT 14J
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10028-7397
Practice Address - Country:US
Practice Address - Phone:212-288-4191
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-26
Last Update Date:2010-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY003007-1225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics