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Individual

JEFFREY L KELLER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
90 S BEDFORD RD, CARE MOUNT MEDICAL PC, MOUNT KISCO, NY 10549-3412
(914) 241-1050
(914) 242-1516
Mailing address
110 S BEDFORD RD, CARE MOUNT MEDICAL PC, MOUNT KISCO, NY 10549-3446
(914) 241-1050
(914) 242-1516

Taxonomy

Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
188631
NY
207YP0228X
Pediatric Otolaryngology Physician
188631
NY
207YX0905X
Otolaryngology/Facial Plastic Surgery Physician
188631
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
01655114
NY
01
0667910001
DME
NY
01
P00421812
MEDICARE RAILROAD
NY
Enumeration date
05/27/2006
Last updated
11/11/2016
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