Provider Demographics
NPI:1891818233
Name:KEATING, LAWRENCE JOHN (MD)
Entity Type:Individual
Prefix:DR
First Name:LAWRENCE
Middle Name:JOHN
Last Name:KEATING
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Gender:M
Credentials:MD
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Mailing Address - Street 1:711 TROY SCHENECTADY RD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:LATHAM
Mailing Address - State:NY
Mailing Address - Zip Code:12110-2442
Mailing Address - Country:US
Mailing Address - Phone:518-213-0478
Mailing Address - Fax:518-782-3799
Practice Address - Street 1:47 NEW SCOTLAND AVE
Practice Address - Street 2:RADIOLOGY DEPARTMENT
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12208-3412
Practice Address - Country:US
Practice Address - Phone:518-262-5149
Practice Address - Fax:518-262-4210
Is Sole Proprietor?:No
Enumeration Date:2007-04-09
Last Update Date:2021-02-26
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Provider Licenses
StateLicense IDTaxonomies
NY2619472085R0202X, 2085R0204X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional Radiology
No2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03353115Medicaid
NY03353115Medicaid