Provider Demographics
NPI:1215100045
Name:KEH, OK JEAN (L AC)
Entity type:Individual
Prefix:MRS
First Name:OK
Middle Name:JEAN
Last Name:KEH
Suffix:
Gender:F
Credentials:L AC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 CAIRNGORM RD
Mailing Address - Street 2:
Mailing Address - City:NEW CITY
Mailing Address - State:NY
Mailing Address - Zip Code:10956-2533
Mailing Address - Country:US
Mailing Address - Phone:845-661-0631
Mailing Address - Fax:845-634-7893
Practice Address - Street 1:11 CAIRNGORM RD
Practice Address - Street 2:
Practice Address - City:NEW CITY
Practice Address - State:NY
Practice Address - Zip Code:10956-2533
Practice Address - Country:US
Practice Address - Phone:845-661-0631
Practice Address - Fax:845-634-7893
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-13
Last Update Date:2008-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY003329-1171100000X
NJ25MZ00056600171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist