Provider Demographics
NPI:1932194941
Name:HASDAY, KEITH HUNTER (DDS)
Entity Type:Individual
Prefix:DR
First Name:KEITH
Middle Name:HUNTER
Last Name:HASDAY
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:132 N PARK AVE
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE CENTRE
Mailing Address - State:NY
Mailing Address - Zip Code:11570-4107
Mailing Address - Country:US
Mailing Address - Phone:516-678-1316
Mailing Address - Fax:516-678-7248
Practice Address - Street 1:132 N PARK AVE
Practice Address - Street 2:
Practice Address - City:ROCKVILLE CENTRE
Practice Address - State:NY
Practice Address - Zip Code:11570-4107
Practice Address - Country:US
Practice Address - Phone:516-678-1316
Practice Address - Fax:516-678-7248
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0403801223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics