Individual
KEITH ALAN CHRISTIANSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
14-01 BROADWAY STE 3, FAIR LAWN, NJ 07410-2008
(201) 855-8455
Mailing address
1401 HUDSON ST, APT 1005, HOBOKEN, NJ 07030-5656
(917) 903-6272
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
25MA08972100
NJ
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
10/08/2008
Last updated
05/15/2018
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