Individual
LISA M KEOUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
750 E ADAMS ST, SYRACUSE, NY 13210-2342
(315) 464-4363
(315) 464-8692
Mailing address
750 E ADAMS ST, SYRACUSE, NY 13210-2342
(315) 464-4363
(315) 464-8692
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
242344
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02830082
—
NY
Enumeration date
11/16/2006
Last updated
01/22/2009
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