MEDICARE: KEVIN KEAR PA-C

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	363A00000X	Physician Assistant	MA056670	PA
2	207X00000X	Orthopaedic Surgery Physician	25MP00329000	NJ

General Provider Information

NPI Number	:	1346667342
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KEVIN KEAR PA-C

Provider Business Mailing Address
First Line	:	3 UNIVERSITY PLZ STE 205
Second Line	:
City	:	HACKENSACK
State	:	NJ
Zip	:	07601-6208
Country	:	US
Telephone Number	:	201-833-3599
Fax Number	:

Provider Business Practice Location Address
First Line	:	870 PALISADE AVE STE 205
Second Line	:
City	:	TEANECK
State	:	NJ
Zip	:	07666-3445
Country	:	US
Telephone Number	:	201-836-1663
Fax Number	:

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

Provider Enumeration Date	:	03/27/2014
Last Update Date	:	09/17/2024

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Directions to “ KEVIN KEAR PA-C” Practice Location

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