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General NPI Number Information
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NPI Number | 1427347459
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Entity Type | Organization
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Legal Business Name | PAUL KESHISHIAN, D.O., P.C.
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Dates
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Enumeration Date | 03/30/2011
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Last Update Date | 04/24/2011
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Provider Practice Location Address
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Address Line | 186 ROCHELLE AVE SUITE #2A
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City | ROCHELLE PARK
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State | NJ
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Zip | 07662-4111
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Country | US
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Telephone | 201-368-3384
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Fax | 201-587-0300
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Provider Business Mailing Address
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Address Line | 186 ROCHELLE AVE SUITE #2A
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City | ROCHELLE PARK
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State | NJ
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Zip | 07662-4111
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Country | US
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Telephone | 201-368-3384
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Fax | 201-587-0300
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. PAUL KESHISHIAN
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Credential | D.O.
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Telephone | 201-368-3384
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | 25MB03905100
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License Number State | NJ
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