Provider Demographics
NPI:1164296919
Name:KESHAV, CARMEN ISABEL (APRN, AGNP-C)
Entity Type:Individual
Prefix:
First Name:CARMEN
Middle Name:ISABEL
Last Name:KESHAV
Suffix:
Gender:F
Credentials:APRN, AGNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 DARTMOUTH CT
Mailing Address - Street 2:
Mailing Address - City:LIVINGSTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07039-1516
Mailing Address - Country:US
Mailing Address - Phone:646-915-4213
Mailing Address - Fax:
Practice Address - Street 1:140 BELMONT AVE STE 102
Practice Address - Street 2:
Practice Address - City:BELLEVILLE
Practice Address - State:NJ
Practice Address - Zip Code:07109-2392
Practice Address - Country:US
Practice Address - Phone:646-915-4213
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-13
Last Update Date:2023-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ14932400363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology