Provider Demographics
NPI:1134468002
Name:KEATING, ADRIAN FRANCIS (COTA)
Entity Type:Individual
Prefix:MR
First Name:ADRIAN
Middle Name:FRANCIS
Last Name:KEATING
Suffix:
Gender:M
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:139 TODDY HILL RD
Mailing Address - Street 2:
Mailing Address - City:SANDY HOOK
Mailing Address - State:CT
Mailing Address - Zip Code:06482-1362
Mailing Address - Country:US
Mailing Address - Phone:203-426-5847
Mailing Address - Fax:
Practice Address - Street 1:139 TODDY HILL RD
Practice Address - Street 2:
Practice Address - City:SANDY HOOK
Practice Address - State:CT
Practice Address - Zip Code:06482-1362
Practice Address - Country:US
Practice Address - Phone:203-426-5847
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-12
Last Update Date:2013-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0013388224Z00000X
MA3586224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant