Provider Demographics
NPI:1477066819
Name:MCKEEBY, MAEVE ABAIGEAL
Entity Type:Individual
Prefix:
First Name:MAEVE
Middle Name:ABAIGEAL
Last Name:MCKEEBY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2031 BURTONVILLE RD
Mailing Address - Street 2:
Mailing Address - City:ESPERANCE
Mailing Address - State:NY
Mailing Address - Zip Code:12066-2415
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2031 BURTONVILLE RD
Practice Address - Street 2:
Practice Address - City:ESPERANCE
Practice Address - State:NY
Practice Address - Zip Code:12066-2415
Practice Address - Country:US
Practice Address - Phone:518-469-6711
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-11-07
Last Update Date:2017-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program