Provider Demographics
NPI:1528207073
Name:JOHN E KEHOE, MD PC
Entity Type:Organization
Organization Name:JOHN E KEHOE, MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:E
Authorized Official - Last Name:KEHOE, MD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-921-3800
Mailing Address - Street 1:200 E 94TH ST
Mailing Address - Street 2:SUITE 1816
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10128-3903
Mailing Address - Country:US
Mailing Address - Phone:718-921-3800
Mailing Address - Fax:718-921-1168
Practice Address - Street 1:9201 4TH AVE FL 6
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11209-7006
Practice Address - Country:US
Practice Address - Phone:718-921-3800
Practice Address - Fax:718-921-1168
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-06
Last Update Date:2009-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086X0206XAllopathic & Osteopathic PhysiciansSurgerySurgical OncologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY230000738OtherRAILROAD MEDICARE
NY149401-NYOther1199
NY029443OtherAETNA
NY100093575001OtherAMERICHOICE BY UNITED HEALTHCARE
NY100093575001OtherAMERICHOICE BY UNITED HEALTHCARE
NYB79417Medicare UPIN