Provider Demographics
NPI:1366925877
Name:CERASO, KAREN LYNN (PT)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:LYNN
Last Name:CERASO
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3333 S BANNOCK ST STE 230
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80110-2484
Mailing Address - Country:US
Mailing Address - Phone:303-862-8853
Mailing Address - Fax:720-379-5827
Practice Address - Street 1:3333 S BANNOCK ST STE 230
Practice Address - Street 2:
Practice Address - City:ENGLEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80110-2484
Practice Address - Country:US
Practice Address - Phone:303-862-8853
Practice Address - Fax:720-379-5827
Is Sole Proprietor?:No
Enumeration Date:2018-09-11
Last Update Date:2018-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPTL.0015835208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation