Provider Demographics
NPI:1376748566
Name:KEASBERRY, CLAUDY-ANN (DC)
Entity Type:Individual
Prefix:DR
First Name:CLAUDY-ANN
Middle Name:
Last Name:KEASBERRY
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33 WOODHILL ST
Mailing Address - Street 2:
Mailing Address - City:SOMERSET
Mailing Address - State:NJ
Mailing Address - Zip Code:08873-4661
Mailing Address - Country:US
Mailing Address - Phone:732-619-3819
Mailing Address - Fax:732-448-1717
Practice Address - Street 1:99 BAYARD ST
Practice Address - Street 2:
Practice Address - City:NEW BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08901-2171
Practice Address - Country:US
Practice Address - Phone:732-448-1616
Practice Address - Fax:732-448-1717
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-18
Last Update Date:2008-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00580400111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ046150U2TMedicare ID - Type Unspecified
NJU84036Medicare UPIN