Provider Demographics
NPI:1437303849
Name:WENTLING, KAREN LORENTSEN (KAREN WENTLING, RPT)
Entity type:Individual
Prefix:MRS
First Name:KAREN
Middle Name:LORENTSEN
Last Name:WENTLING
Suffix:
Gender:F
Credentials:KAREN WENTLING, RPT
Other - Prefix:
Other - First Name:KAREN
Other - Middle Name:
Other - Last Name:LORENTSEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:172 W 79TH ST
Mailing Address - Street 2:APT 12FG
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10024-6419
Mailing Address - Country:US
Mailing Address - Phone:917-441-4322
Mailing Address - Fax:
Practice Address - Street 1:172 W 79TH ST
Practice Address - Street 2:APT 12FG
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10024-6419
Practice Address - Country:US
Practice Address - Phone:917-441-4322
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-12
Last Update Date:2008-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY007781-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist