Provider Demographics
NPI:1982971586
Name:PRUZANSKY, KAREN I (MA, CCC, SLP)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:I
Last Name:PRUZANSKY
Suffix:
Gender:F
Credentials:MA, CCC, SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1390 SOMERSET GATE
Mailing Address - Street 2:
Mailing Address - City:TEANECK
Mailing Address - State:NJ
Mailing Address - Zip Code:07666-2163
Mailing Address - Country:US
Mailing Address - Phone:201-928-1969
Mailing Address - Fax:
Practice Address - Street 1:2433 E TREMONT AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10461-2801
Practice Address - Country:US
Practice Address - Phone:718-409-4227
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-27
Last Update Date:2011-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY004863-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist