Provider Demographics
NPI:1528095072
Name:KEATING, THOMAS (DC)
Entity type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:
Last Name:KEATING
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 1:524 S NEW YORK RD
Mailing Address - Street 2:
Mailing Address - City:GALLOWAY
Mailing Address - State:NJ
Mailing Address - Zip Code:08205-9720
Mailing Address - Country:US
Mailing Address - Phone:609-748-3001
Mailing Address - Fax:609-748-3002
Practice Address - Street 1:524 S NEW YORK RD
Practice Address - Street 2:
Practice Address - City:GALLOWAY
Practice Address - State:NJ
Practice Address - Zip Code:08205-9720
Practice Address - Country:US
Practice Address - Phone:609-748-3001
Practice Address - Fax:609-748-3002
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-27
Last Update Date:2021-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00702900111N00000X
NY010950111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYX7M541Medicare ID - Type Unspecified
NYV01835Medicare UPIN