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General NPI Number Information
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NPI Number | 1588763353
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Entity Type | Individual
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Provider Name | ELIZABETH M KEANE MD
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Gender | Female
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Dates
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Enumeration Date | 09/21/2006
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Last Update Date | 08/04/2008
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Provider Practice Location Address
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Address Line | 145 HOLLIS STREET
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City | MANCHESTER
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State | NH
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Zip | 03101-1235
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Country | US
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Telephone | 603-626-9500
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Fax | 606-626-0899
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Provider Business Mailing Address
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Address Line | 143 NORTH MAIN ST
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City | MONT VERNON
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State | NH
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Zip | 03057
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Country | US
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Telephone | 603-663-8060
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 9043
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License Number State | NH
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