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General NPI Number Information
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NPI Number | 1912136177
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Entity Type | Individual
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Provider Name | MR. ROBERT EDWARD O'KEEFE
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Gender | Male
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Dates
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Enumeration Date | 07/09/2009
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Last Update Date | 07/09/2009
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Provider Practice Location Address
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Address Line | 31 FLIRTATION AVE
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City | NEW PRESTON
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State | CT
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Zip | 06777-1709
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Country | US
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Telephone | 860-868-2868
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Fax |
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Provider Business Mailing Address
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Address Line | 31 FLIRTATION AVENUE
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City | NEW PRESTON
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State | CT
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Zip | 06777
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Country | US
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Telephone | 860-868-2868
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 001605
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License Number State | CT
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