Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207PE0004X | Emergency Medical Services | 001178-1 | NY |
NPI | 1205092285 |
---|---|
Provider Name | Annmarie Keane |
First Address | Garden City, NY 11530-2621 |
Second Address | Jamaica, NY 11418-2832 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/07/2008 |
Last Update Date | 30/07/2008 |