Basic Information
Provider Information
NPI: 1578916631
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: PAZZI
FirstName: KARLA
MiddleName: M
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 680 AMERICAN AVE
Address2: SUITE 302
City: KING OF PRUSSIA
State: PA
PostalCode: 194064023
CountryCode: US
TelephoneNumber: 6106446464
FaxNumber: 6109816078
Practice Location
Address1: 175 KING OF PRUSSIA RD
Address2:  
City: RADNOR
State: PA
PostalCode: 190874521
CountryCode: US
TelephoneNumber: 6106446464
FaxNumber: 6109816078
Other Information
ProviderEnumerationDate: 07/13/2016
LastUpdateDate: 07/13/2016
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
104100000XSW131061PAY Behavioral Health & Social Service ProvidersSocial Worker 

No ID Information.


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