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NPI Code Detail

MEDICARE: CANDACE L. O KEEFE PA

MEDICARE: CANDACE L. O KEEFE PA
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
1363A00000XPhysician AssistantPA3846MA

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
3P00269488OTHERCTMEDICARE RAILROAD

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1000726OTHERCTCTCARE
2290000726CT02OTHERCTANTHEM

General Provider Information

NPI Number : 1396708780
Entity Type Code : Individual
Provider Name (Legal Business Name) : CANDACE L. O KEEFE PA
Provider Business Mailing Address
First Line : 200 MILL RD
Second Line :
City : FAIRHAVEN
State : MA
Zip : 02719-5252
Country : US
Telephone Number : 508-973-2000
Fax Number :
Provider Business Practice Location Address
First Line : 235 HANOVER ST
Second Line :
City : FALL RIVER
State : MA
Zip : 02720-5246
Country : US
Telephone Number : 508-973-1750
Fax Number : 508-235-6658
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/08/2006
Last Update Date : 06/06/2024

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Directions to “ CANDACE L. O KEEFE PA” Practice Location

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