Individual
KEIRON W GREAVES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
300 2ND AVE, LONG BRANCH, NJ 07740-6303
(732) 222-5200
Mailing address
PO BOX 1637, ELIZABETH, NJ 07207-1637
(201) 804-2800
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
25MA05952100
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6392008
—
NJ
Enumeration date
06/30/2005
Last updated
07/12/2010
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