MEDICARE: DR. STEPHEN KEENAN D.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	111N00000X	Chiropractor	X008327	NY

General Provider Information

NPI Number	:	1386772523
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. STEPHEN KEENAN D.C.

Provider Business Mailing Address
First Line	:	1134 77TH ST
Second Line	:	CHIROPRACTIC CARE CENTER
City	:	BROOKLYN
State	:	NY
Zip	:	11228-2336
Country	:	US
Telephone Number	:	718-513-3333
Fax Number	:	718-513-3335

Provider Business Practice Location Address
First Line	:	1134 77TH ST
Second Line	:	CHIROPRACTIC CARE CENTER 2ND FLOOR
City	:	BROOKLYN
State	:	NY
Zip	:	11228-2336
Country	:	US
Telephone Number	:	718-513-3333
Fax Number	:	718-513-3335

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

Provider Enumeration Date	:	03/01/2007
Last Update Date	:	05/15/2014

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