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General NPI Number Information
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NPI Number | 1174532022
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Entity Type | Individual
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Provider Name | ISIDORE MICHAEL KEIMAN M.D.
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Gender | Male
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Dates
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Enumeration Date | 08/07/2006
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Last Update Date | 09/10/2012
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Provider Practice Location Address
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Address Line | 469 CLIFTON AVENUE
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City | CLIFTON
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State | NJ
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Zip | 07011
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Country | US
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Telephone | 973-253-0266
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Fax | 973-253-0399
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Provider Business Mailing Address
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Address Line | 14 ALFRED LN APT C
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City | BLOOMFIELD
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State | NJ
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Zip | 07003-6218
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Country | US
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Telephone | 973-945-6918
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Fax | 973-253-0399
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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 | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 25MA07763000
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License Number State | NJ
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