Provider Demographics
NPI:1386772523
Name:KEENAN, STEPHEN (DC)
Entity type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:
Last Name:KEENAN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1134 77TH ST
Mailing Address - Street 2:CHIROPRACTIC CARE CENTER
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11228-2336
Mailing Address - Country:US
Mailing Address - Phone:718-513-3333
Mailing Address - Fax:718-513-3335
Practice Address - Street 1:1134 77TH ST
Practice Address - Street 2:CHIROPRACTIC CARE CENTER 2ND FLOOR
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11228-2336
Practice Address - Country:US
Practice Address - Phone:718-513-3333
Practice Address - Fax:718-513-3335
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-01
Last Update Date:2014-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX008327111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYX4D981Medicare PIN