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NPI Code Detail

MEDICARE: DR. KEITH F DOCKERY M.D.

MEDICARE: DR. KEITH F DOCKERY 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
1207UN0902XNuclear Imaging & Therapy Physician25MA09089800NJ
22085R0202XDiagnostic Radiology Physician244698NY
32085R0202XDiagnostic Radiology Physician25MA09089800NJ

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1972512754
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. KEITH F DOCKERY M.D.
Provider Business Mailing Address
First Line : 19 GLENWOOD DR
Second Line :
City : SADDLE RIVER
State : NJ
Zip : 07458-3303
Country : US
Telephone Number : 201-485-7893
Fax Number :
Provider Business Practice Location Address
First Line : 223 N VAN DIEN AVE
Second Line :
City : RIDGEWOOD
State : NJ
Zip : 07450-2726
Country : US
Telephone Number : 201-447-8210
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/07/2006
Last Update Date : 03/04/2026

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Directions to “ DR. KEITH F DOCKERY M.D.” Practice Location

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