Provider Demographics
NPI:1508076761
Name:KERI L LIVINGSTONE MD PA
Entity Type:Organization
Organization Name:KERI L LIVINGSTONE MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRES
Authorized Official - Prefix:DR
Authorized Official - First Name:KERI
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:LIVINGSTONE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-751-8071
Mailing Address - Street 1:660 NE 95TH ST
Mailing Address - Street 2:SUITE 1
Mailing Address - City:MIAMI SHORES
Mailing Address - State:FL
Mailing Address - Zip Code:33138-2758
Mailing Address - Country:US
Mailing Address - Phone:305-751-8071
Mailing Address - Fax:305-751-3045
Practice Address - Street 1:660 NE 95TH ST
Practice Address - Street 2:SUITE 1
Practice Address - City:MIAMI SHORES
Practice Address - State:FL
Practice Address - Zip Code:33138-2758
Practice Address - Country:US
Practice Address - Phone:305-751-8071
Practice Address - Fax:305-751-3045
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-23
Last Update Date:2011-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty