Healthcare Provider Details

I. General information

NPI: 1255334850
Provider Name (Legal Business Name): JAMES OKEEFFE M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/27/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

45 HUDSON AVE
GLENS FALLS NY
12801-4313
US

IV. Provider business mailing address

45 HUDSON AVE PO BOX 144
GLENS FALLS NY
12801-4313
US

V. Phone/Fax

Practice location:
  • Phone: 518-793-4477
  • Fax: 518-798-7541
Mailing address:
  • Phone: 518-793-4477
  • Fax: 518-798-7541

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License Number126053
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: