Provider Demographics
NPI:1619097037
Name:KEATING, CATHERINE BONHAM (MD)
Entity Type:Individual
Prefix:DR
First Name:CATHERINE
Middle Name:BONHAM
Last Name:KEATING
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 1:44 MANSION BLVD
Mailing Address - Street 2:APT. H
Mailing Address - City:DELMAR
Mailing Address - State:NY
Mailing Address - Zip Code:12054-2456
Mailing Address - Country:US
Mailing Address - Phone:646-339-9081
Mailing Address - Fax:
Practice Address - Street 1:208 DELAWARE AVE
Practice Address - Street 2:
Practice Address - City:DELMAR
Practice Address - State:NY
Practice Address - Zip Code:12054-1231
Practice Address - Country:US
Practice Address - Phone:518-439-5611
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-30
Last Update Date:2011-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA225620208000000X
NY262904-1208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics