Individual
MARYELLEN KEENAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
153 W 12TH ST, NEW YORK, NY 10011-8201
(212) 604-8177
(212) 604-7568
Mailing address
153 W 12TH ST, NEW YORK, NY 10011-8201
(212) 604-8177
(212) 604-7568
Taxonomy
Speciality
Code
Description
License number
State
163WP0809X
Adult Psychiatric/Mental Health Registered Nurse
Primary
329271
NY
Other
Enumeration date
09/10/2008
Last updated
09/10/2008
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