Provider Demographics
NPI:1316172182
Name:O'KEEFE, CONNER MICHAEL (MD)
Entity type:Individual
Prefix:DR
First Name:CONNER
Middle Name:MICHAEL
Last Name:O'KEEFE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:222 HIGH STREET
Mailing Address - Street 2:SUITE 205
Mailing Address - City:NEWTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07860
Mailing Address - Country:US
Mailing Address - Phone:973-579-2100
Mailing Address - Fax:973-579-6638
Practice Address - Street 1:CARDIOLOGY ASSOCIATES OF SUSSEX COUNTY
Practice Address - Street 2:222 HIGH ST. SUITE 205
Practice Address - City:NEWTON
Practice Address - State:NJ
Practice Address - Zip Code:07860
Practice Address - Country:US
Practice Address - Phone:973-579-2100
Practice Address - Fax:973-579-6638
Is Sole Proprietor?:No
Enumeration Date:2009-05-22
Last Update Date:2021-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036.129453207RI0011X
WI63998207RI0011X
IN01076990B207RI0011X
NJ25MA11036600207RI0011X, 207RC0000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN201382900Medicaid