Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207V00000X | Obstetrician & Gynecologist | 153617-1 | NY |
NPI | 1023012788 |
---|---|
Provider Name | Kathryn O'keeffe |
First Address | Glens Falls, NY 12801-4313 |
Second Address | Glens Falls, NY 12801-4313 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/06/2005 |
Last Update Date | 07/01/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000496210002 | BLUE SHIELD (01) | NY |
00785511 | (05) | NY |
040426007605 | FIDELIS (01) | NY |
10002780 | CDPHP (01) | NY |
15166 | MVP (01) | NY |
160012993 | RAILROAD MEDICARE (01) | NY |
35F881 | BLUE CROSS (01) | NY |
B80739 | (02) | NY |