Individual
KEITH ALAN CHADWICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD, MS
Contact information
Practice address
4 SMITH HAVEN MALL STE 200, LAKE GROVE, NY 11755-1219
(631) 444-4121
(631) 444-4189
Mailing address
PO BOX 1559, STONY BROOK, NY 11790-0989
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
294203
NY
390200000X
Student in an Organized Health Care Education/Training Program
0116025714
VA
390200000X
Student in an Organized Health Care Education/Training Program
PG168015
OR
Other
Enumeration date
06/02/2013
Last updated
02/15/2026
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