Keklak, C. Stephen

Keklak, C. Stephen is an individual health care provider with primary practice located at 901 W Main St Medical Arts Building, Freehold NJ 07728-2537. He recently has only one registered license in Allopathic & Osteopathic Physicians / Diagnostic Radiology, which is considered as his primary health care specialty. Keklak, C. Stephen can be contacted via phone (732) 462-3302.

Contact Information

Primary practice address
901 W Main St Medical Arts Building Freehold NJ 07728-2537
Phone: (732) 462-3302
Fax: (732) 780-6213
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X 25MA03233300 New Jersey

Profile Details

NPI number 1164440053
LBN Legal business name Keklak, C. Stephen
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 18th, 2006
Last updated Aug 31st, 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 1164440053 NPPES
New Jersey MEDICAID 2051508

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