Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204D00000X | Neuromusculoskeletal Medicine (NMM) | 172829 | NY |
NPI | 1417051731 |
---|---|
Provider Name | Nadine Jennifer Keegan |
First Address | Palisades, NY 10964-0143 |
Second Address | New York, NY 10128-0143 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/09/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
E94736 | (02) | NY |
N52796 | OXFORD PROVIDER (01) | NY |
P363740 | OXFORD PROVIDER (01) | NY |