Individual
COLLEEN KEATING
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1434 110TH ST, APT 4I, COLLEGE POINT, NY 11356-1446
(917) 328-0704
Mailing address
1434 110TH STREET, APT 4I, COLLEGE POINT, NY 11356
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
686679121
NY
174400000X
Specialist
686683121
NY
Other
Enumeration date
12/02/2013
Last updated
12/02/2013
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