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Individual
MR. SCOTT KEATLEY
Active
Individual
MR. SCOTT KEATLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RD, CDN
Taxonomy
Speciality
Code
Description
License number
State
133N00000X
Nutritionist
009107
NY
133V00000X
Registered Dietitian
Primary
—
—
133VN1005X
Renal Nutrition Registered Dietitian
009107
NY
133VN1006X
Metabolic Nutrition Registered Dietitian
009107
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
009107
NYS REGISTRATION
NY
01
—
06090442
BLUE CROSS BLUE SHIELD
NY
01
—
6004111
AETNA
NY
01
—
75762436
CIGNA
NY
01
—
NU009107
HEALTHFIRST
NY
Enumeration date
06/15/2016
Last updated
01/21/2025
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