Individual
MS. KIMBERLY KEANE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
800 HOWARD AVE, NEW HAVEN, CT 06519
(203) 785-2579
(203) 785-7132
Mailing address
2408 WHITNEY AVE, HAMDEN, CT 06518-3209
(203) 752-3100
(203) 752-9291
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
000272
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1538148069
—
CT
Enumeration date
01/12/2006
Last updated
07/25/2018
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