Individual
DR. KEITH S NUSSBAUM
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
469 ALBANY SHAKER RD, LOUDONVILLE, NY 12211-1586
(518) 482-6175
(518) 459-5134
Mailing address
124 GLEN HOLLOW RD, SLINGERLANDS, NY 12159-3718
(518) 573-0644
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
X005850-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10001492
CDPHP
NY
01
—
98L1994
MVP
NY
Enumeration date
06/14/2006
Last updated
07/08/2007
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