Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 176B00000X | Midwife | F000401-1 | NY |
NPI | 1013915206 |
---|---|
Provider Name | Denise S Keppel |
First Address | Brooklyn, NY 11219-2919 |
Second Address | Brooklyn, NY 11219-2919 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/07/2005 |
Last Update Date | 10/02/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01534945 | (05) | NY |
58585 | (02) | NY |