Provider Demographics
NPI:1366567182
Name:LITTLE, KAREN ANN (MSPT)
Entity type:Individual
Prefix:MS
First Name:KAREN
Middle Name:ANN
Last Name:LITTLE
Suffix:
Gender:F
Credentials:MSPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:108 OLD CAHOONZIE ROAD
Mailing Address - Street 2:
Mailing Address - City:SPARROW BUSH
Mailing Address - State:NY
Mailing Address - Zip Code:12780-5556
Mailing Address - Country:US
Mailing Address - Phone:845-858-7000
Mailing Address - Fax:
Practice Address - Street 1:160 E MAIN ST
Practice Address - Street 2:
Practice Address - City:PORT JERVIS
Practice Address - State:NY
Practice Address - Zip Code:12771-2114
Practice Address - Country:US
Practice Address - Phone:845-858-7000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-20
Last Update Date:2008-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY13401-1225100000X
PAPT019472225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist