Keckeisen, George D
Keckeisen, George D is an individual health care provider with primary practice located at 325 Meeting House Ln Bldg #2, Southampton NY 11968-5087. He recently has only one registered license in Allopathic & Osteopathic Physicians / Vascular Surgery, which is considered as his primary health care specialty. Keckeisen, George D can be contacted via phone (631) 283-2100.Contact Information
Primary practice address
325 Meeting House Ln Bldg #2
Southampton NY 11968-5087
Phone: (631) 283-2100
Fax: (631) 283-5731
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Allopathic & Osteopathic Physicians / Vascular Surgery | 2086S0129X | 151417 | New York |
Profile Details
NPI number | 1619072436 |
---|---|
LBN Legal business name | Keckeisen, George D |
Credentials | Doctor of Medicine (MD) |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Sep 14th, 2006 |
Last updated | Jan 11th, 2011 - about 13 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 | 1619072436 | NPPES |
New York | MEDICAID | 01521420 | |
New York | Other | 27263 |
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