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NPI Code Detail

MEDICARE: DR. BRIAN ROBERT KEEGAN M.D., PH. D.

MEDICARE: DR. BRIAN ROBERT KEEGAN M.D., PH. D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207N00000XDermatology Physician25MA08659700NJ

General Provider Information

NPI Number : 1053516351
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. BRIAN ROBERT KEEGAN M.D., PH. D.
Provider Business Mailing Address
First Line : 59 ONE MILE RD EXT
Second Line : SUITE G
City : EAST WINDSOR
State : NJ
Zip : 08520-2505
Country : US
Telephone Number : 609-619-3433
Fax Number : 609-426-0530
Provider Business Practice Location Address
First Line : 59 ONE MILE RD EXT
Second Line : SUITE G
City : EAST WINDSOR
State : NJ
Zip : 08520-2505
Country : US
Telephone Number : 609-619-3433
Fax Number : 609-426-0530
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/18/2007
Last Update Date : 10/23/2013

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