Provider Demographics
NPI:1881104339
Name:DANCHALSKI, KAREN MICHELLE
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:MICHELLE
Last Name:DANCHALSKI
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 1:89 LANDING RD
Mailing Address - Street 2:
Mailing Address - City:GLEN COVE
Mailing Address - State:NY
Mailing Address - Zip Code:11542-1817
Mailing Address - Country:US
Mailing Address - Phone:516-509-2423
Mailing Address - Fax:
Practice Address - Street 1:3 SCHOOL ST STE 205
Practice Address - Street 2:
Practice Address - City:GLEN COVE
Practice Address - State:NY
Practice Address - Zip Code:11542-2548
Practice Address - Country:US
Practice Address - Phone:516-676-2327
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-10
Last Update Date:2017-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY025853-12251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic