Provider Demographics
NPI:1922008705
Name:KEE, MITSU A (MD)
Entity Type:Individual
Prefix:DR
First Name:MITSU
Middle Name:A
Last Name:KEE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1770 MOTOR PKWY
Mailing Address - Street 2:
Mailing Address - City:ISLANDIA
Mailing Address - State:NY
Mailing Address - Zip Code:11749-5260
Mailing Address - Country:US
Mailing Address - Phone:631-434-1770
Mailing Address - Fax:631-234-6175
Practice Address - Street 1:1770 MOTOR PKWY
Practice Address - Street 2:
Practice Address - City:ISLANDIA
Practice Address - State:NY
Practice Address - Zip Code:11749-5260
Practice Address - Country:US
Practice Address - Phone:631-434-1770
Practice Address - Fax:631-234-6175
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-07-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY214537208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYG73624Medicare UPIN