Provider Demographics
NPI:1699017848
Name:JOHNS-KEATING, KRYSTA (MD/MPH)
Entity type:Individual
Prefix:DR
First Name:KRYSTA
Middle Name:
Last Name:JOHNS-KEATING
Suffix:
Gender:F
Credentials:MD/MPH
Other - Prefix:
Other - First Name:KRYSTA
Other - Middle Name:
Other - Last Name:JOHNS-HARRIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD,MPH
Mailing Address - Street 1:301 LIPPINCOTT DR STE 410
Mailing Address - Street 2:
Mailing Address - City:MARLTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08053-4197
Mailing Address - Country:US
Mailing Address - Phone:856-355-0340
Mailing Address - Fax:856-355-0330
Practice Address - Street 1:1945 MARLTON PIKE E STE D
Practice Address - Street 2:
Practice Address - City:CHERRY HILL
Practice Address - State:NJ
Practice Address - Zip Code:08003-2160
Practice Address - Country:US
Practice Address - Phone:856-237-8045
Practice Address - Fax:856-237-8047
Is Sole Proprietor?:No
Enumeration Date:2013-03-25
Last Update Date:2024-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA10451500207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0711349Medicaid