Provider Demographics
NPI:1639127814
Name:O'KEEFFE, DAVID A (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:A
Last Name:O'KEEFFE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:425 ESSJAY RD STE 170
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14221-8235
Mailing Address - Country:US
Mailing Address - Phone:716-630-1219
Mailing Address - Fax:716-817-1726
Practice Address - Street 1:3900 N BUFFALO ST
Practice Address - Street 2:
Practice Address - City:ORCHARD PARK
Practice Address - State:NY
Practice Address - Zip Code:14127-1842
Practice Address - Country:US
Practice Address - Phone:716-656-4805
Practice Address - Fax:716-250-5927
Is Sole Proprietor?:No
Enumeration Date:2006-05-04
Last Update Date:2021-12-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY168848-1207QS0010X
NY1688848-1207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207QS0010XAllopathic & Osteopathic PhysiciansFamily MedicineSports Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY080048498OtherRR MEDICARE
NY0105916OtherIHA
NY01075016Medicaid
NY161000580OtherNOVA
NY161000580OtherEMPIRE
NY00010129501OtherUNIVERA
NY161000580OtherNORLTH AMERICAN PREFERRED
NY168848-0WOtherWORKERS COMPENSATION
NY000510334002OtherHEALTH NOW
NY161000580OtherNOVA
NY01075016Medicaid