Provider Demographics
NPI:1891128138
Name:KEODARA, ARMSTRONG KEY (OD)
Entity Type:Individual
Prefix:DR
First Name:ARMSTRONG
Middle Name:KEY
Last Name:KEODARA
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3966 65TH PL
Mailing Address - Street 2:
Mailing Address - City:WOODSIDE
Mailing Address - State:NY
Mailing Address - Zip Code:11377-3781
Mailing Address - Country:US
Mailing Address - Phone:864-921-0600
Mailing Address - Fax:
Practice Address - Street 1:265 ASHLAND PL
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11217-1661
Practice Address - Country:US
Practice Address - Phone:864-921-0600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-09
Last Update Date:2018-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0082111152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist