Healthcare Provider Details

I. General information

NPI: 1952513160
Provider Name (Legal Business Name): TERRAH M. KECK-KESTER M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: TERRAH M KECK

II. Dates (important events)

Enumeration Date: 05/03/2007
Last Update Date: 04/18/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

121 N NYES RD STE D
HARRISBURG PA
17112-3248
US

IV. Provider business mailing address

PO BOX 858 MC A410
HERSHEY PA
17033-0858
US

V. Phone/Fax

Practice location:
  • Phone: 717-531-8674
  • Fax: 717-531-0401
Mailing address:
  • Phone: 800-243-1455
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberMD436301
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: