Provider Demographics
NPI:1194794131
Name:MARROCCO, KAREN E (ATC)
Entity type:Individual
Prefix:MS
First Name:KAREN
Middle Name:E
Last Name:MARROCCO
Suffix:
Gender:F
Credentials:ATC
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Mailing Address - Street 1:54 W AVON RD
Mailing Address - Street 2:SUITE 202
Mailing Address - City:AVON
Mailing Address - State:CT
Mailing Address - Zip Code:06001-3680
Mailing Address - Country:US
Mailing Address - Phone:860-675-0357
Mailing Address - Fax:860-675-0358
Practice Address - Street 1:54 W AVON RD
Practice Address - Street 2:SUITE 202
Practice Address - City:AVON
Practice Address - State:CT
Practice Address - Zip Code:06001-3680
Practice Address - Country:US
Practice Address - Phone:860-675-0357
Practice Address - Fax:860-675-0358
Is Sole Proprietor?:No
Enumeration Date:2006-03-14
Last Update Date:2007-10-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CT0001662255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT000166OtherSTATE CT LICENSE