Provider Demographics
NPI:1912242280
Name:CARTER, KATRINA (PT, DPT)
Entity Type:Individual
Prefix:
First Name:KATRINA
Middle Name:
Last Name:CARTER
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1377 MOTOR PKWY STE 307
Mailing Address - Street 2:
Mailing Address - City:ISLANDIA
Mailing Address - State:NY
Mailing Address - Zip Code:11749-5258
Mailing Address - Country:US
Mailing Address - Phone:914-294-4050
Mailing Address - Fax:630-760-8306
Practice Address - Street 1:704 N JUDD PKWY NE STE 100
Practice Address - Street 2:
Practice Address - City:FUQUAY VARINA
Practice Address - State:NC
Practice Address - Zip Code:27526-1989
Practice Address - Country:US
Practice Address - Phone:919-896-7158
Practice Address - Fax:919-896-7208
Is Sole Proprietor?:No
Enumeration Date:2012-11-28
Last Update Date:2023-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA01471800225100000X
CT11161225100000X
NCP22613225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist