Individual
DR. MARIA R KEANCHONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
20 PROSPECT AVE, SUITE 810, HACKENSACK, NJ 07601-1997
(201) 880-4949
(201) 880-4950
Mailing address
20 PROSPECT AVE, SUITE 810, HACKENSACK, NJ 07601-1997
(201) 880-4949
(201) 880-4950
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
MA59792
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6963404
—
NJ
Enumeration date
04/07/2006
Last updated
01/05/2010
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