Provider Demographics
NPI:1528068954
Name:KEILSON, MARSHALL J (MD)
Entity type:Individual
Prefix:DR
First Name:MARSHALL
Middle Name:J
Last Name:KEILSON
Suffix:
Gender:M
Credentials:MD
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Other - Credentials:
Mailing Address - Street 1:2044 OCEAN AVE
Mailing Address - Street 2:SUITE A8
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11230-7393
Mailing Address - Country:US
Mailing Address - Phone:718-759-6065
Mailing Address - Fax:347-587-3919
Practice Address - Street 1:2044 OCEAN AVE
Practice Address - Street 2:SUITE A8
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11230-7393
Practice Address - Country:US
Practice Address - Phone:718-759-6065
Practice Address - Fax:347-587-3919
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-28
Last Update Date:2014-01-23
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY134726204C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes204C00000XAllopathic & Osteopathic PhysiciansNeuromusculoskeletal Medicine, Sports Medicine