Basic Information
Provider Information
NPI: 1891833745
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: MATTHEWS-LEARY
FirstName: KAREN
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: PT
OtherOrganizationName:  
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OtherCredential:  
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Mailing Information
Address1: 181 PATRICIA GENOVA DRIVE
Address2: EASTERN REHABILITATION NETWORK (5TH FLOOR)
City: NEWINGTON
State: CT
PostalCode: 06111
CountryCode: US
TelephoneNumber: 8606675480
FaxNumber: 8606678416
Practice Location
Address1: 181 PATRICIA GENOVA DRIVE
Address2: EASTERN REHABILITATION NETWORK (5TH FLOOR)
City: NEWINGTON
State: CT
PostalCode: 06111
CountryCode: US
TelephoneNumber: 8606675480
FaxNumber: 8606678416
Other Information
ProviderEnumerationDate: 02/02/2007
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
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AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225100000X4288CTY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist 

No ID Information.


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