MR. SCOTT KEATLEY (NPI# 1619327129) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619327129 |
| Entity Type | Individual |
| Full Name | MR. SCOTT KEATLEY |
| Credential | RD, CDN |
| Practice Address |
596 Broadway Ste 302 New York NY 10012-3396 |
| Mailing Address |
869 Park Ave Apt 2a Brooklyn NY 11206-7334 |
| Practice Telephone | 8005718276 |
| Practice Fax Number | 8889740289 |
| Mailing Telephone | 8005718276 |
| Mailing Fax Number | 8889740289 |
| Enumeration Date | 2016-06-15 |
| Last Update Date | 2020-10-23 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 133N00000X | Nutritionist | 009107 | NY | Dietary & Nutritional Service Providers |
| N | 133V00000X | Dietitian, Registered | Dietary & Nutritional Service Providers | ||
| N | 133VN1005X |
Dietitian, Registered Specialization: Nutrition, Renal |
009107 | NY | Dietary & Nutritional Service Providers |
| Y | 133VN1006X |
Dietitian, Registered Specialization: Nutrition, Metabolic |
009107 | NY | Dietary & Nutritional Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | NYS REGISTRATION | 009107 | 01 |
| NY | BLUE CROSS BLUE SHIELD | 06090442 | 01 |
| NY | AETNA | 6004111 | 01 |
| NY | HEALTHFIRST | NU009107 | 01 |
| NY | CIGNA | 75762436 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 26 Court St Ste 2709, Brooklyn, NY 112421127 | 8005718276 | 8889740289 |
| Street Address |
596 BROADWAY STE 302 |
| City | NEW YORK |
| State | NY |
| Zip Code | 10012-3396 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164775649 | Gina Angel Keatley | Nutritionist | 596 Broadway, Suite 302, New York, NY 10012-3396 | 2012-10-20 |
| 1497939912 | Stephanie L. White | Physical Therapist | 596 Broadway, Suite 302, New York, NY 10012-3396 | 2007-12-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609481514 | John James Makohen | Counselor | Greenwish House Mmtp, 190 Mercer St, New York, NY 10012 | 2020-09-09 |
| 1962016980 | Aliceia Dolma Carin | Acupuncturist | 51 Spring St #14, New York, NY 10012 | 2020-09-08 |
| 1073127544 | Stacy E Garrity | Nurse Practitioner | 453 W Broadway, New York, NY 10012 | 2020-09-02 |
| 1558863761 | Shurla S Perry | Counselor | 96 W Houston St, New York, NY 10012 | 2018-03-03 |
| 1295246361 | Charlotta Noelle Nutley-phillips | Speech-Language Pathologist | 654 Broadway #2f, 654 Broadway, New York, NY 10012 | 2017-10-17 |
| 1023496163 | Kelley Pauline Hershman | Counselor | 159 Bleecker St Apt 2a, New York, NY 10012 | 2015-05-08 |
| 1134514599 | Frank Joseph Vogt | Acupuncturist | 73 Spring St., Suite 201, New York, NY 10012 | 2015-04-02 |
| 1063816932 | Howard Schatz | Orthopaedic Surgery | 435 West Broadway, #2, New York, NY 10012 | 2014-10-21 |
| 1649680737 | Charlotte Aronin Birnbaum | Dermatology | 73 Spring Street, Suite 303, New York, NY 10012 | 2014-04-29 |
| 1841600988 | Jeffrey Cohen Mental Health Counseling, P.C. | Counselor | 14 East 4th Street, Suite 506, New York, NY 10012 | 2014-04-29 |
| Find all providers in zip 10012 | ||||
| Taxonomy Code | 133VN1006X |
| Grouping | Dietary & Nutritional Service Providers |
| Classification | Dietitian, Registered |
| Specialization | Nutrition, Metabolic |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770994741 | Juliana Martinez | Dietitian, Registered | 430 West 34th St, Apt. 3k, New York, NY 10001-2310 | 2014-05-13 |
| 1467898528 | Ilona Ginevic | Dietitian, Registered | One Gustave L. Levy Place, Box 1497, New York, NY 10029 | 2013-05-16 |
| 1184850950 | Susan J Vannucci | Dietitian, Registered | 315 W 106th St Apt 3d, New York, NY 10025-3473 | 2009-06-06 |
| 1437390531 | Carla Wolper | Dietitian, Registered | 1090 Amsterdam Ave # 14c, New York, NY 10025-1737 | 2009-03-19 |
| 1861691792 | Corinne Lee Furnari | Dietitian, Registered | 250 W 49th St Ste 503, New York, NY 10019-7433 | 2007-07-11 |
| 1457555450 | Jessica Nicole Melzer | Dietitian, Registered | 66 W 88th St, Apt 1 G, New York, NY 10024-2503 | 2007-06-13 |
| 1831247428 | Amy Stephens | Dietitian, Registered | 39 Washington Square South, #1w, New York, NY 10012 | 2007-01-08 |
| 1184727042 | Alenka Maria Ravnik-list | Dietitian, Registered | One Gustave Levy Place, Box 1067, New York, NY 10029-6574 | 2006-09-06 |
| 1447791108 | Tara Condell | Dietitian, Registered | 347 5th Ave, 606, New York, NY 10016-5010 | 2017-03-14 |
| 1285058107 | Kontosnutrition Inc. | Dietitian, Registered | 425 Central Park W, Suite # 6e, New York, NY 10025-4381 | 2014-02-12 |
| Find all providers in NEW YORK | ||||
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| 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.