MEDICARE: GWENN S O'KEEFFE M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208000000X	Pediatrics Physician	205039	MA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	205039	OTHER	MA	TUFTS
3	J22828	OTHER	MA	BLUE CROSS
4	AA26004	OTHER	MA	HARVARD PILGRIM
5	0020248	OTHER	MA	NEIGHBORHOOD HEALTH

General Provider Information

NPI Number	:	1245201375
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GWENN S O'KEEFFE M.D.

Provider Business Mailing Address
First Line	:	41 DEER PATH
Second Line	:
City	:	HUDSON
State	:	MA
Zip	:	01749-2639
Country	:	US
Telephone Number	:	617-803-0709
Fax Number	:

Provider Business Practice Location Address
First Line	:	910 BOSTON TPKE STE 3
Second Line	:
City	:	SHREWSBURY
State	:	MA
Zip	:	01545-3396
Country	:	US
Telephone Number	:	617-966-1260
Fax Number	:	617-762-1278

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/27/2006
Last Update Date	:	06/06/2024

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