Provider Demographics
NPI:1851683981
Name:KEEFE, JANET BUTERA (MD)
Entity Type:Individual
Prefix:DR
First Name:JANET
Middle Name:BUTERA
Last Name:KEEFE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:188 COLUMBIA HTS
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11201-2105
Mailing Address - Country:US
Mailing Address - Phone:718-522-6028
Mailing Address - Fax:718-625-7138
Practice Address - Street 1:188 COLUMBIA HTS
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11201-2105
Practice Address - Country:US
Practice Address - Phone:718-522-6028
Practice Address - Fax:718-625-7138
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-09
Last Update Date:2011-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY155737207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY53D091Medicare PIN
NYA63150Medicare UPIN