Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
JENNIFER KELLER
Active Sole ProprietorPhysical Disabilities Residential Treatment Facility · PECONIC, NY
Registration Details
- NPI Number
- 1578821385
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Apr 30, 2012 (13.977675091085 yrs)
- Last Updated
- Apr 30, 2012
- License
-
494793 (NY)
- Sole Proprietor
- Yes
Practice Information
- Address
-
1190 ARROWHEAD LNPECONIC, NY, 119581602Browse NY providers · Browse ZIP 11958
- Phone
- 6316802010
- Primary Specialty
-
Physical Disabilities Residential Treatment Facility
320700000X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.