Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207N00000X | Dermatologist | 25MA08659700 | NJ |
NPI | 1053516351 |
---|---|
Provider Name | Dr. Brian Robert Keegan |
First Address | East Windsor, NJ 08520-2505 |
Second Address | East Windsor, NJ 08520-2505 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/06/2007 |
Last Update Date | 23/10/2013 |