Individual
MRS. MARIE KEOGH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MPH, RD, CDN, IBCLC
Contact information
Practice address
12335 82ND RD, APT 4K, KEW GARDENS, NY 11415-1611
(516) 978-2190
Mailing address
12335 82ND RD, APT 4K, KEW GARDENS, NY 11415-1611
(516) 978-2190
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
006939-1
NY
174N00000X
Lactation Consultant (Non-RN)
L-104888
NY
Other
Enumeration date
09/04/2014
Last updated
01/19/2017
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