Provider Demographics
NPI:1154552628
Name:KERR, KAREN GERTRUDIS (MED,CCC-SLP)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:GERTRUDIS
Last Name:KERR
Suffix:
Gender:F
Credentials:MED,CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1605 ANN ST
Mailing Address - Street 2:#2
Mailing Address - City:FORT LEE
Mailing Address - State:NJ
Mailing Address - Zip Code:07024-2608
Mailing Address - Country:US
Mailing Address - Phone:718-578-8011
Mailing Address - Fax:201-482-0639
Practice Address - Street 1:1605 ANN ST
Practice Address - Street 2:#2
Practice Address - City:FORT LEE
Practice Address - State:NJ
Practice Address - Zip Code:07024-2608
Practice Address - Country:US
Practice Address - Phone:718-578-8011
Practice Address - Fax:201-482-0639
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-01
Last Update Date:2009-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY015168-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist