Healthcare Provider Details

I. General information

NPI: 1962403816
Provider Name (Legal Business Name): HENRY M KEYS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/02/2005
Last Update Date: 01/27/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 FOX CARE DR SUITE 310
ONEONTA NY
13820-2086
US

IV. Provider business mailing address

PO BOX 8510 HENRY M KEYS MD
ALBANY NY
12208-0510
US

V. Phone/Fax

Practice location:
  • Phone: 607-431-5075
  • Fax: 607-431-5191
Mailing address:
  • Phone: 607-431-5475
  • Fax: 607-431-5191

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License Number110659
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: