Individual
JILLIAN ROSE KEATING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
800 WASHINGTON STREET, TUFTS MC BOX #306, BOSTON, MA 02111
(617) 636-5172
Mailing address
16 MORGAN WAY, LATHAM, NY 12110-5522
(518) 209-3124
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/13/2020
Last updated
11/25/2022
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