Keanchong, Maria R

Keanchong, Maria R is an individual health care provider with primary practice located at 20 Prospect Ave Suite 810, Hackensack NJ 07601-1997. She recently has only one registered license in Allopathic & Osteopathic Physicians / Obstetrics & Gynecology, which is considered as her primary health care specialty. Keanchong, Maria R can be contacted via phone (201) 880-4949.

Contact Information

Primary practice address
20 Prospect Ave Suite 810 Hackensack NJ 07601-1997
Phone: (201) 880-4949
Fax: (201) 880-4950
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Obstetrics & Gynecology 207V00000X MA59792 New Jersey

Profile Details

NPI number 1174586788
LBN Legal business name Keanchong, Maria R
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 7th, 2006
Last updated Jan 5th, 2010 - about 16 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1174586788 NPPES
New Jersey MEDICAID 6963404

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