Provider Demographics
NPI:1508209560
Name:RICHARDS, KEENAN ROBERT (MD)
Entity Type:Individual
Prefix:DR
First Name:KEENAN
Middle Name:ROBERT
Last Name:RICHARDS
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Gender:M
Credentials:MD
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Mailing Address - Street 1:19 BRADHURST AVE STE 3100N
Mailing Address - Street 2:
Mailing Address - City:HAWTHORNE
Mailing Address - State:NY
Mailing Address - Zip Code:10532-2140
Mailing Address - Country:US
Mailing Address - Phone:914-909-9018
Mailing Address - Fax:914-909-9028
Practice Address - Street 1:396 BROADWAY
Practice Address - Street 2:
Practice Address - City:KINGSTON
Practice Address - State:NY
Practice Address - Zip Code:12401-4626
Practice Address - Country:US
Practice Address - Phone:845-331-3131
Practice Address - Fax:845-331-2530
Is Sole Proprietor?:No
Enumeration Date:2013-04-09
Last Update Date:2020-10-30
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Provider Licenses
StateLicense IDTaxonomies
NY295436207L00000X, 207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology