Provider Demographics
NPI:1720488372
Name:KEYES, CRAIG W (MD)
Entity Type:Individual
Prefix:
First Name:CRAIG
Middle Name:W
Last Name:KEYES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 MORNINGSIDE DR
Mailing Address - Street 2:APT. 1607
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10025-2422
Mailing Address - Country:US
Mailing Address - Phone:917-328-7141
Mailing Address - Fax:
Practice Address - Street 1:1 MORNINGSIDE DR
Practice Address - Street 2:APT. 1607
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10025-2422
Practice Address - Country:US
Practice Address - Phone:917-328-7141
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-02
Last Update Date:2014-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY164655207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine