Fraser, Keith Evan
Fraser, Keith Evan is an individual health care provider with primary practice located at 134 Evergreen Pl 3Rd Floor, East Orange NJ 07018-2011. He recently has only one registered license in Other Service Providers / Specialist, which is considered as his primary health care specialty. Fraser, Keith Evan can be contacted via phone (973) 678-8144.Contact Information
Primary practice address
134 Evergreen Pl 3Rd Floor
East Orange NJ 07018-2011
Phone: (973) 678-8144
Fax: (973) 678-2830
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Other Service Providers / Specialist | 174400000X | 53154 | New Jersey |
Profile Details
| NPI number | 1881621266 |
|---|---|
| LBN Legal business name | Fraser, Keith Evan |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 28th, 2006 |
| Last updated | Jul 8th, 2007 - about 19 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1881621266 | NPPES |
| New Jersey | Other | P1278567 | OXFORD |
| New Jersey | Other | 0K7327 | OXFORD |
| New Jersey | Other | 44430 | OXFORD |
| New Jersey | Other | 0383367000 | OXFORD |
| New Jersey | Other | 0980497 | OXFORD |
| New Jersey | Other | 1018005 | OXFORD |
| New Jersey | MEDICAID | 3417301 | OXFORD |
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