Provider Demographics
NPI:1629072368
Name:O'KEEFE, PETER MICHAEL (DO)
Entity Type:Individual
Prefix:DR
First Name:PETER
Middle Name:MICHAEL
Last Name:O'KEEFE
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 FRANKLIN AVE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:GARDEN CITY
Mailing Address - State:NY
Mailing Address - Zip Code:11530-2926
Mailing Address - Country:US
Mailing Address - Phone:516-248-8334
Mailing Address - Fax:516-248-1357
Practice Address - Street 1:1000 FRANKLIN AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:GARDEN CITY
Practice Address - State:NY
Practice Address - Zip Code:11530-2926
Practice Address - Country:US
Practice Address - Phone:516-248-8334
Practice Address - Fax:516-248-1357
Is Sole Proprietor?:No
Enumeration Date:2005-06-10
Last Update Date:2021-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY228450208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02571084Medicaid
NY02571084Medicaid