Individual
DR. RANDY KEEGAN IDLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
50 STANIFORD ST, BOSTON, MA 02114-2517
(617) 903-5000
Mailing address
8502 FORT HAMILTON PKWY APT 3B, BROOKLYN, NY 11209-4816
(775) 636-0076
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
1019991
MA
207Q00000X
Family Medicine Physician
Primary
325526
NY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/11/2020
Last updated
09/19/2024
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