Healthcare Provider Details

I. General information

NPI: 1326466129
Provider Name (Legal Business Name): SARINA MARIE KEOGH PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SARINA MARIE MOLINARI PA-C

II. Dates (important events)

Enumeration Date: 03/31/2014
Last Update Date: 07/08/2026
Certification Date: 07/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19 DAVIS AVE FL 2
NEPTUNE NJ
07753-4488
US

IV. Provider business mailing address

331 NEWMAN SPRINGS RD STE 220
RED BANK NJ
07701-5792
US

V. Phone/Fax

Practice location:
  • Phone: 732-776-3690
  • Fax: 732-776-3691
Mailing address:
  • Phone: 732-807-0877
  • Fax: 201-751-1680

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License Number25MP00331100
License Number StateNJ
# 2
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number25MP00331100
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: