Ancona, Keith G
Ancona, Keith G is an individual health care provider with primary practice located at 300 E Main St Suite 5, Smithtown NY 11787-2900. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as his primary health care specialty. Ancona, Keith G can be contacted via phone (631) 979-6466.Contact Information
Primary practice address
300 E Main St Suite 5
Smithtown NY 11787-2900
Phone: (631) 979-6466
Fax: (631) 979-6475
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | 221658 | New York |
Profile Details
| NPI number | 1619934205 |
|---|---|
| LBN Legal business name | Ancona, Keith G |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Apr 27th, 2006 |
| Last updated | Jul 8th, 2007 - about 17 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1619934205 | NPPES |
| New York | MEDICAID | 02413734 |
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