Provider Demographics
NPI:1881972057
Name:MARRERO, KAREN (LAC)
Entity type:Individual
Prefix:MISS
First Name:KAREN
Middle Name:
Last Name:MARRERO
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 FORT WASHINGTON AVE APT 6A
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10033-6839
Mailing Address - Country:US
Mailing Address - Phone:718-844-0105
Mailing Address - Fax:
Practice Address - Street 1:400 FORT WASHINGTON AVE APT 6A
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10033-6839
Practice Address - Country:US
Practice Address - Phone:718-844-0105
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-21
Last Update Date:2011-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY004483-1171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist