Provider Demographics
NPI:1467481846
Name:O'KEEFE, MARY (MD)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:
Last Name:O'KEEFE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 MULE RD
Mailing Address - Street 2:
Mailing Address - City:TOMS RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:08755-5043
Mailing Address - Country:US
Mailing Address - Phone:732-818-0004
Mailing Address - Fax:732-818-7775
Practice Address - Street 1:9 MULE RD
Practice Address - Street 2:OCEAN COUNTY FAMILY CARE
Practice Address - City:TOMS RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08755-5043
Practice Address - Country:US
Practice Address - Phone:732-818-0004
Practice Address - Fax:732-818-7775
Is Sole Proprietor?:No
Enumeration Date:2006-06-30
Last Update Date:2010-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA06111600207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJF36856Medicare UPIN
NJ503413Medicare PIN