Provider Demographics
NPI:1821267782
Name:DRAGO, KEITH JOSEPH (CPNP)
Entity Type:Individual
Prefix:MR
First Name:KEITH
Middle Name:JOSEPH
Last Name:DRAGO
Suffix:
Gender:M
Credentials:CPNP
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 191
Mailing Address - Street 2:PROVIDER ENROLLMENT DEPT
Mailing Address - City:ROCKLAND
Mailing Address - State:DE
Mailing Address - Zip Code:19732-0191
Mailing Address - Country:US
Mailing Address - Phone:302-651-6212
Mailing Address - Fax:302-651-4945
Practice Address - Street 1:1600 ROCKLAND RD
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19803-3607
Practice Address - Country:US
Practice Address - Phone:302-651-4334
Practice Address - Fax:302-651-4041
Is Sole Proprietor?:No
Enumeration Date:2008-02-25
Last Update Date:2012-01-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
DEL1-0030111163WP0200X
PARN530634L163WP0200X
DELJ-0000241363LP0200X
PASP009665363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
No163WP0200XNursing Service ProvidersRegistered NursePediatrics