Provider Demographics
NPI:1164517413
Name:HOERNING, KEITH R (DO)
Entity Type:Individual
Prefix:DR
First Name:KEITH
Middle Name:R
Last Name:HOERNING
Suffix:
Gender:M
Credentials:DO
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Mailing Address - Street 1:67 LEE AVE
Mailing Address - Street 2:
Mailing Address - City:BABYLON
Mailing Address - State:NY
Mailing Address - Zip Code:11702-4210
Mailing Address - Country:US
Mailing Address - Phone:631-539-2594
Mailing Address - Fax:631-539-2594
Practice Address - Street 1:290 SUNRISE HWY
Practice Address - Street 2:
Practice Address - City:LINDENHURST
Practice Address - State:NY
Practice Address - Zip Code:11757-2520
Practice Address - Country:US
Practice Address - Phone:631-226-3600
Practice Address - Fax:631-226-3607
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-03
Last Update Date:2023-09-11
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Provider Licenses
StateLicense IDTaxonomies
NY223257207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine