Healthcare Provider Details

I. General information

NPI: 1700248663
Provider Name (Legal Business Name): LAURA K KEENEY D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LAURA K HACKENBERGER D.O.

II. Dates (important events)

Enumeration Date: 03/22/2016
Last Update Date: 08/23/2024
Certification Date: 08/23/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 PINE GROVE CMNS
YORK PA
17403-5176
US

IV. Provider business mailing address

601 MEMORY LN
YORK PA
17402-2231
US

V. Phone/Fax

Practice location:
  • Phone: 717-851-6110
  • Fax: 717-741-1076
Mailing address:
  • Phone: 717-851-1405
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2086S0127X
TaxonomyTrauma Surgery Physician
License NumberOS022884
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code2086S0102X
TaxonomySurgical Critical Care Physician
License NumberOS022884
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: