Provider Demographics
NPI:1295430007
Name:STEPHENY, KEITH ANTHONY
Entity type:Individual
Prefix:
First Name:KEITH
Middle Name:ANTHONY
Last Name:STEPHENY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:34 BANK ST APT 2104
Mailing Address - Street 2:
Mailing Address - City:NETCONG
Mailing Address - State:NJ
Mailing Address - Zip Code:07857-1031
Mailing Address - Country:US
Mailing Address - Phone:609-733-2676
Mailing Address - Fax:
Practice Address - Street 1:34 BANK ST APT 2104
Practice Address - Street 2:
Practice Address - City:NETCONG
Practice Address - State:NJ
Practice Address - Zip Code:07857-1031
Practice Address - Country:US
Practice Address - Phone:609-733-2676
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-03
Last Update Date:2023-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)