Paul Henry Keckeisen, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

002975 Issued in NY

Practice address

120 Plant Ave
Hauppauge, NY 11788-3805

Phone

(631) 273-1300

Fax

(631) 851-3865

NPI assigned

Oct 24, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1161648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1287705600000",
    "number": "1366525982",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9 W SPRUCE ST",
            "city": "ISLIP",
            "state": "NY",
            "postal_code": "117512713",
            "telephone_number": "631-650-5572"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 PLANT AVE",
            "city": "HAUPPAUGE",
            "state": "NY",
            "postal_code": "117883805",
            "telephone_number": "631-273-1300",
            "fax_number": "631-851-3865"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KECKEISEN",
        "first_name": "PAUL",
        "middle_name": "HENRY",
        "name_prefix": "Mr.",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-24",
        "last_updated": "2010-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "NY",
            "license": "002975",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anubhav Kaul, M.D.
• Sandeep Kaur
• Heloise Alice Kayser, MHC
• Kevin J. Kearney, PSY.D.
• Barbara A Kearns, AUDIOLOGIST
• Alex Ryan Kehoe, LCSW
• Cheryl S Kelly, NP
• Lori Ann Kelly, R.N.
• Michael Khalili, MD
• Sumaya Khanfri

• Physical Therapy Assistant in Hauppauge, NY
• Providers in Hauppauge, NY by specialty
• Physical Therapy Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.