Individual
KYLE KEANE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
285 SILLS RD BLDG 18, EAST PATCHOGUE, NY 11772
(631) 475-1224
(631) 475-1588
Mailing address
285 SILLS RD BLDG 18, EAST PATCHOGUE, NY 11772-4808
(631) 475-1224
(631) 475-1588
Taxonomy
Speciality
Code
Description
License number
State
207QS0010X
Sports Medicine (Family Medicine) Physician
Primary
281433
NY
Other
Enumeration date
04/29/2014
Last updated
08/15/2019
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