Provider Demographics
NPI:1912136177
Name:O'KEEFE, ROBERT EDWARD
Entity type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:EDWARD
Last Name:O'KEEFE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31 FLIRTATION AVENUE
Mailing Address - Street 2:
Mailing Address - City:NEW PRESTON
Mailing Address - State:CT
Mailing Address - Zip Code:06777
Mailing Address - Country:US
Mailing Address - Phone:860-868-2868
Mailing Address - Fax:
Practice Address - Street 1:31 FLIRTATION AVE
Practice Address - Street 2:
Practice Address - City:NEW PRESTON
Practice Address - State:CT
Practice Address - Zip Code:06777-1709
Practice Address - Country:US
Practice Address - Phone:860-868-2868
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-09
Last Update Date:2009-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0016051041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical