Individual
MR. PAUL HENRY KECKEISEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
120 PLANT AVE, HAUPPAUGE, NY 11788-3805
(631) 273-1300
(631) 851-3865
Mailing address
9 W SPRUCE ST, ISLIP, NY 11751-2713
(631) 650-5572
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
002975
NY
Other
Enumeration date
10/24/2006
Last updated
10/22/2010
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