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NPI Code Detail

MEDICARE: DR. ERIC NELSON KELLER D.C.

MEDICARE: DR. ERIC NELSON KELLER 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
1111N00000XChiropractorX005648NY

General Provider Information

NPI Number : 1972692044
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ERIC NELSON KELLER D.C.
Provider Business Mailing Address
First Line : 4350 VAN CORTLANDT PARK E
Second Line :
City : BRONX
State : NY
Zip : 10470-1875
Country : US
Telephone Number : 914-237-2434
Fax Number :
Provider Business Practice Location Address
First Line : 4350 VAN CORTLANDT PARK E
Second Line :
City : BRONX
State : NY
Zip : 10470-1875
Country : US
Telephone Number : 914-234-2434
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/12/2006
Last Update Date : 07/21/2022

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