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Individual

KEISHA ALIX HAMPDEN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
355 GRAND ST, JERSEY CITY, NJ 07302-4321
(201) 915-2000
Mailing address
309 KILLOUGH CIR, BIRMINGHAM, AL 35215-6907

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
7855658
NY
207L00000X
Anesthesiology Physician
Primary
129950
PR

Other

Enumeration date
08/14/2020
Last updated
05/04/2021
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