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General NPI Number Information
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NPI Number | 1821090648
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Entity Type | Individual
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Provider Name | WARREN D KELLER PH.D.
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Gender | Male
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Dates
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Enumeration Date | 08/11/2005
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Last Update Date | 04/08/2017
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Provider Practice Location Address
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Address Line | 8175 SHERIDAN DR STE 200
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City | WILLIAMSVILLE
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State | NY
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Zip | 14221-6002
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Country | US
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Telephone | 716-634-2600
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Fax | 716-634-2675
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Provider Business Mailing Address
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Address Line | 9750 TRANSIT RD
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City | EAST AMHERST
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State | NY
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Zip | 14051-2124
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Country | US
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Telephone | 716-636-1375
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Fax | 716-636-4501
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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 | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 07489
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License Number State | NY
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