Individual
KEEGAN J WHITE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
5141 BROADWAY, NEW YORK, NY 10034-1159
(585) 953-7296
Mailing address
67 DERRICK DR, W HENRIETTA, NY 14586-8914
(585) 953-7296
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
—
—
Other
Enumeration date
06/15/2022
Last updated
06/15/2022
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