Individual
MS. FREDERIQUE KELLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
L.AC
Contact information
Practice address
408 FORT SALONGA RD, NORTHPORT, NY 11768-3075
(631) 351-3521
Mailing address
15 HEIGHTS RD, NORTHPORT, NY 11768-2626
(631) 351-3521
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
990
NY
Other
Enumeration date
01/21/2021
Last updated
01/21/2021
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