Healthcare Provider Details

I. General information

NPI: 1720126840
Provider Name (Legal Business Name): KAREN ANDERSON KEITH PHD, RN, FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/01/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

37 W 26TH ST NEW ALTERNATIVES FOR CHILDREN, 7TH FLOOR
NEW YORK NY
10010-1006
US

IV. Provider business mailing address

165 SHERIDAN AVE
MOUNT VERNON NY
10552-2003
US

V. Phone/Fax

Practice location:
  • Phone: 212-696-1550
  • Fax: 212-545-7375
Mailing address:
  • Phone: 914-434-1679
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number33 330538
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: