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General NPI Number Information
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NPI Number | 1093932659
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Entity Type | Organization
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Legal Business Name | KEITH HOERNING DOCTORS CARE
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Dates
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Enumeration Date | 04/18/2007
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Last Update Date | 06/17/2022
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Provider Practice Location Address
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Address Line | 290 EAST SUNRISE HWY
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City | LINDENHURST
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State | NY
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Zip | 11757
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Country | US
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Telephone | 631-226-3600
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Fax | 631-991-7535
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Provider Business Mailing Address
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Address Line | 290 EAST SUNRISE HWY
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City | LINDENHURST
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State | NY
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Zip | 11757
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Country | US
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Telephone | 631-226-3600
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Fax | 631-991-7535
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Authorized Official
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Title or Position | PROVIDER
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Name | KEITH R HOERNING
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Credential | D.O.
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Telephone | 631-276-3600
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number |
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License Number State |
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