Healthcare Provider Details

I. General information

NPI: 1497391825
Provider Name (Legal Business Name): KEAN A DEY FOY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/20/2019
Last Update Date: 11/20/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6605 242ND ST
LITTLE NECK NY
11362-2084
US

IV. Provider business mailing address

6605 242ND ST
LITTLE NECK NY
11362-2084
US

V. Phone/Fax

Practice location:
  • Phone: 516-443-3893
  • Fax:
Mailing address:
  • Phone: 516-443-3893
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number003529
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: