Provider Demographics
NPI:1992095731
Name:KEENEY, LAUREN GEORGIADES (DO)
Entity type:Individual
Prefix:DR
First Name:LAUREN
Middle Name:GEORGIADES
Last Name:KEENEY
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:937 E HAVERFORD RD STE 100
Mailing Address - Street 2:
Mailing Address - City:BRYN MAWR
Mailing Address - State:PA
Mailing Address - Zip Code:19010-3800
Mailing Address - Country:US
Mailing Address - Phone:732-742-1204
Mailing Address - Fax:
Practice Address - Street 1:937 E HAVERFORD RD STE 100
Practice Address - Street 2:
Practice Address - City:BRYN MAWR
Practice Address - State:PA
Practice Address - Zip Code:19010-3800
Practice Address - Country:US
Practice Address - Phone:732-742-1204
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-04-13
Last Update Date:2022-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOT014016207L00000X, 390200000X
WI76842207L00000X
NY278308-1207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program