DR. GEORGE D KECKEISEN (NPI# 1619072436) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619072436 |
| Entity Type | Individual |
| Full Name | DR. GEORGE D KECKEISEN |
| Credential | MD |
| Practice Address |
325 Meeting House Ln Bldg #2 Southampton NY 11968-5087 |
| Mailing Address |
Po Box 2340 Southampton NY 11969-2340 |
| Practice Telephone | 6312832100 |
| Practice Fax Number | 6312835731 |
| Mailing Telephone | 6312832430 |
| Mailing Fax Number | 6312837496 |
| Enumeration Date | 2006-09-14 |
| Last Update Date | 2011-01-11 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2086S0129X |
Surgery Specialization: Vascular Surgery |
151417 | NY | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | 01521420 | 05 | |
| NY | VYTRA | 27263 | 01 |
| Street Address |
325 MEETING HOUSE LN BLDG #2 |
| City | SOUTHAMPTON |
| State | NY |
| Zip Code | 11968-5087 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841290608 | Louis M Goldblum | Pediatrics | 325 Meeting House Ln, Southampton, NY 11968 | 2005-07-22 |
| 1700323326 | Sara Procak | Physician Assistant | 325 Meeting House Ln, Southampton, NY 11968-5087 | 2017-01-20 |
| 1699189191 | Hamptons Vein & Vascular PC | Specialist | 325 Meeting House Ln, Bldg 1, Suite A, Southampton, NY 11968-5087 | 2014-06-12 |
| 1538503487 | James Wai | Internal Medicine | 325 Meeting House Ln, Bldg 2 Suite 403, Southampton, NY 11968 | 2013-04-22 |
| 1295964740 | Southampton Physical Therapy PC | Clinic/Center | 325 Meeting House Ln, Southampton, NY 11968-5087 | 2009-07-06 |
| 1659508570 | Rajeev Santiago Fernando | Internal Medicine | 325 Meeting House Ln, Building #2, Southampton, NY 11968-5087 | 2009-06-18 |
| 1730325721 | Thelma Barker Gaetano | Pediatrics | 325 Meeting House Ln, Southampton, NY 11968-5087 | 2008-12-23 |
| 1134385909 | Olga L Mcabee | Psychiatry & Neurology | 325 Meeting House Ln, Bldg #2 1st Suite 301, Southampton, NY 11968-5087 | 2008-07-31 |
| 1013182591 | Lawrence J Tarasuk | Surgery | 325 Meeting House Ln, Bldg 2 Suite 403, Southampton, NY 11968-5087 | 2008-04-25 |
| 1689842379 | Brian Park | Dentist | 325 Meeting House Ln, Bldg #2 Suite 401, Southampton, NY 11968-5087 | 2008-02-14 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992333553 | Adam Spinner | Student in an Organized Health Care Education/Training Program | Stony Brook Southampton General Surgery, 240 Meeting House Lane, Southampton, NY 11968 | 2020-03-30 |
| 1538725205 | Blossom Counseling Services | Clinic/Center | 225 Old Point Rd, Southampton, NY 11968 | 2019-05-17 |
| 1386184679 | Oscar F. Mandes | Social Worker | 57 Hampton Road, Suite 201, Southampton, NY 11968 | 2017-03-06 |
| 1346780046 | Jacqueline Chantal Rosante | Physician Assistant | Meeting House Lane Medical Practice, PC Surgical Spec., 240, Southampton, NY 11968 | 2017-02-28 |
| 1316377260 | Empire Osteopathy LLC | Neuromusculoskeletal Medicine & OMM | 332a Canoe Place Road, Southampton, NY 11968 | 2013-11-13 |
| 1619225984 | Elizabeth Hope Piselli | Podiatrist | 365 County Road 39a Unit 9, Southampton, NY 11968 | 2012-08-16 |
| 1902164965 | University Hospital At Stony Brook | Clinic/Center | Church Street, Southampton, NY 11968 | 2012-04-27 |
| 1588933170 | Lindsey Dargan | Speech-Language Pathologist | 141 Narrow Lane, Southampton, NY 11968 | 2011-12-28 |
| 1013249069 | Justina Savarese | Speech-Language Pathologist | 168 Hill Street, Southampton, NY 11968 | 2010-02-02 |
| 1164541918 | Maria Radu | Dentist | 39 Inlet Rd East, Southampton, NY 11968 | 2007-03-29 |
| Find all providers in zip 11968 | ||||
| Taxonomy Code | 2086S0129X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| Specialization | Vascular Surgery |
| A surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962003509 | Gs Medical, P.C. | Surgery | 377-b Pearsall Ave, Cedarhurst, NY 11516 | 2020-11-02 |
| 1073128971 | New York Vascular Group, Pllc | Surgery | 19 Laurel Ave Ste 102, Cornwall, NY 12518-1403 | 2020-09-09 |
| 1578190179 | Camilo Jose Martinez | Surgery | 23 S Howell Ave Ste H, Centereach, NY 11720-4445 | 2020-03-24 |
| 1407483399 | Interventional Medicine | Surgery | 1122a Coney Island Ave, Brooklyn, NY 11230-2307 | 2020-03-23 |
| 1487287975 | Syracuse Professional Medical Services of New York LLC | Surgery | 1101 Erie Blvd E Ste 201a, Syracuse, NY 13210-1144 | 2020-02-13 |
| 1457983181 | Syracuse Medical of New York LLC | Surgery | 1101 Erie Blvd E Ste 201b, Syracuse, NY 13210-1144 | 2020-02-11 |
| 1366914483 | Star Veins Centers PC | Surgery | 225 W 35th St Frnt 2, New York, NY 10001-1904 | 2018-12-31 |
| 1528547312 | Norwood Professional Medical Services of New York LLC | Surgery | 3487-89 Jerome Ave, Ste A, Bronx, NY 10468 | 2018-08-13 |
| 1336628130 | Norwood Medical of New York LLC | Surgery | 3487-89 Jerome Ave, Ste B, Bronx, NY 10468 | 2018-08-13 |
| 1003393299 | Bushwick Professional Medical Services of New York LLC | Surgery | 441 Knickerbocker Ave Ste A, Brooklyn, NY 11237-4508 | 2018-07-20 |
| Find all providers with the same taxonomy | ||||
| City | SOUTHAMPTON |
| Zip Code | 11968 |
Please comment or provide details below to improve the information on DR. GEORGE D KECKEISEN.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.