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NPI Code Detail

MEDICARE: DR. RONI M KELLER M.D.

MEDICARE: DR. RONI M KELLER 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
1207Y00000XOtolaryngology Physician262959NY

General Provider Information

NPI Number : 1497920839
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. RONI M KELLER M.D.
Provider Business Mailing Address
First Line : 660 WHITE PLAINS RD STE 400
Second Line :
City : TARRYTOWN
State : NY
Zip : 10591-5107
Country : US
Telephone Number : 914-984-2546
Fax Number :
Provider Business Practice Location Address
First Line : 3526 FRANCIS LEWIS BLVD
Second Line :
City : FLUSHING
State : NY
Zip : 11358-1954
Country : US
Telephone Number : 718-631-8899
Fax Number : 718-631-4401
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/28/2008
Last Update Date : 12/27/2023

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