Provider Demographics
NPI:1972527646
Name:ZEITLIN, KEITH F (ND)
Entity Type:Individual
Prefix:DR
First Name:KEITH
Middle Name:F
Last Name:ZEITLIN
Suffix:
Gender:M
Credentials:ND
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Mailing Address - Street 1:850 N MAIN STREET EXT
Mailing Address - Street 2:BUILDING 2, SUITE 3B
Mailing Address - City:WALLINGFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06492-2400
Mailing Address - Country:US
Mailing Address - Phone:203-284-1119
Mailing Address - Fax:203-284-1050
Practice Address - Street 1:850 N MAIN STREET EXT
Practice Address - Street 2:BUILDING 2, SUITE 3B
Practice Address - City:WALLINGFORD
Practice Address - State:CT
Practice Address - Zip Code:06492-2400
Practice Address - Country:US
Practice Address - Phone:203-284-1119
Practice Address - Fax:203-284-1050
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000224175F00000X
WA1030175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath