Healthcare Provider Details

I. General information

NPI: 1245320951
Provider Name (Legal Business Name): HAROLD D KEISER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/13/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

MONTEFIORE MEDICAL PARK 1515 BLONDELL AVENUE, STE. 220
BRONX NY
10461
US

IV. Provider business mailing address

606 MAITLAND AVE
TEANECK NJ
07666-2201
US

V. Phone/Fax

Practice location:
  • Phone: 718-405-8323
  • Fax:
Mailing address:
  • Phone: 718-405-8323
  • Fax: 718-405-8322

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License Number105395
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: