Provider Demographics
NPI:1992945422
Name:H. B. KESHAVA, M.D., P.C.
Entity type:Organization
Organization Name:H. B. KESHAVA, M.D., P.C.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:H.
Authorized Official - Middle Name:B
Authorized Official - Last Name:KESHAVA,
Authorized Official - Suffix:
Authorized Official - Credentials:MD, PC
Authorized Official - Phone:518-752-5160
Mailing Address - Street 1:1185 COUNTY HIGHWAY 122
Mailing Address - Street 2:
Mailing Address - City:GLOVERSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:12078-6140
Mailing Address - Country:US
Mailing Address - Phone:518-752-5160
Mailing Address - Fax:518-752-5160
Practice Address - Street 1:1185 COUNTY HIGHWAY 122
Practice Address - Street 2:
Practice Address - City:GLOVERSVILLE
Practice Address - State:NY
Practice Address - Zip Code:12078-6140
Practice Address - Country:US
Practice Address - Phone:518-752-5160
Practice Address - Fax:518-752-5160
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:H. B. KESHAVA, M.D., P.C.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-02-24
Last Update Date:2016-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY19483207LC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207LC0200XAllopathic & Osteopathic PhysiciansAnesthesiologyCritical Care MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYJ100000126Medicare PIN