Individual
SHANE KEOGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
33-57 HARRISON ST, JOHNSON CITY, NY 13790-2107
(607) 763-6674
(607) 798-1629
Mailing address
346 GRAND AVE, JOHNSON CITY, NY 13790-2580
(607) 763-6674
(607) 798-1629
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
D0091217
MD
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/20/2015
Last updated
06/07/2021
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