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Individual

KEITH J DEGI

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
230 W 17TH ST, 7TH FLOOR, NEW YORK, NY 10011-5325
(212) 523-6500
(212) 523-8555
Mailing address
PO BOX 95000-2240, PHILADELPHIA, PA 19195-0001
(212) 523-6500
(212) 523-8555

Taxonomy

Speciality
Code
Description
License number
State
2084A0401X
Addiction Medicine (Psychiatry & Neurology) Physician
211218
NY
2084P0800X
Psychiatry Physician
Primary
211218
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
02267307
NY
01
A400045011
MEDICARE PTAN
Enumeration date
02/26/2007
Last updated
10/02/2012
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