Provider Demographics
NPI:1699049320
Name:ELIAS, KAREN KONDOS (DPT)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:KONDOS
Last Name:ELIAS
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:KAREN
Other - Middle Name:K
Other - Last Name:KONDOS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DPT
Mailing Address - Street 1:315 FORSGATE DR
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:NJ
Mailing Address - Zip Code:08831-1539
Mailing Address - Country:US
Mailing Address - Phone:732-485-5221
Mailing Address - Fax:
Practice Address - Street 1:315 FORSGATE DR
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:NJ
Practice Address - Zip Code:08831-1539
Practice Address - Country:US
Practice Address - Phone:732-485-5221
Practice Address - Fax:609-395-9955
Is Sole Proprietor?:No
Enumeration Date:2012-02-27
Last Update Date:2022-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA01435300225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist