Provider Demographics
NPI:1225088248
Name:KEO, NARON I (MD)
Entity Type:Individual
Prefix:DR
First Name:NARON
Middle Name:I
Last Name:KEO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 725
Mailing Address - Street 2:
Mailing Address - City:COOPERSTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:13326-0725
Mailing Address - Country:US
Mailing Address - Phone:607-369-2771
Mailing Address - Fax:607-369-2276
Practice Address - Street 1:16 CLIFTON STREET
Practice Address - Street 2:
Practice Address - City:UNADILLA
Practice Address - State:NY
Practice Address - Zip Code:13849-1301
Practice Address - Country:US
Practice Address - Phone:607-369-2271
Practice Address - Fax:607-369-2276
Is Sole Proprietor?:No
Enumeration Date:2006-05-11
Last Update Date:2008-02-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY212715207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01902038Medicaid
NYG40029Medicare UPIN
NY01902038Medicaid