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General NPI Number Information
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NPI Number | 1023215225
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Entity Type | Individual
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Provider Name | KEITH STANLEY USISKIN MD
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Gender | Male
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Dates
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Enumeration Date | 06/29/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | FAMILY HEALTH CENTER 100 SOUTH STREET
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City | MORRISTOWN
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State | NJ
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Zip | 07960
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Country | US
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Telephone | 973-889-6800
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Fax |
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Provider Business Mailing Address
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Address Line | 3 OGDEN RD
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City | MENDHAM
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State | NJ
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Zip | 07945-1811
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Country | US
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Telephone | 908-432-4605
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RE0101X
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Taxonomy Name | Endocrinology, Diabetes & Metabolism Physician
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License Number | MA053053
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License Number State | NJ
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