Healthcare Provider Details

I. General information

NPI: 1528207073
Provider Name (Legal Business Name): JOHN E KEHOE, MD PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/06/2009
Last Update Date: 02/06/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9201 4TH AVE FL 6
BROOKLYN NY
11209-7006
US

IV. Provider business mailing address

200 E 94TH ST SUITE 1816
NEW YORK NY
10128-3903
US

V. Phone/Fax

Practice location:
  • Phone: 718-921-3800
  • Fax: 718-921-1168
Mailing address:
  • Phone: 718-921-3800
  • Fax: 718-921-1168

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086X0206X
TaxonomySurgical Oncology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. JOHN E KEHOE, MD
Title or Position: CEO
Credential: MD
Phone: 718-921-3800