Provider Demographics
NPI:1447323019
Name:UTICA EMERGENCY PHYSICIANS, PC
Entity type:Organization
Organization Name:UTICA EMERGENCY PHYSICIANS, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:G
Authorized Official - Last Name:KEENE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:518-751-1016
Mailing Address - Street 1:802 COLUMBIA ST
Mailing Address - Street 2:SUITE 2
Mailing Address - City:HUDSON
Mailing Address - State:NY
Mailing Address - Zip Code:12534-2306
Mailing Address - Country:US
Mailing Address - Phone:518-751-1016
Mailing Address - Fax:
Practice Address - Street 1:1656 CHAMPLIN AVE
Practice Address - Street 2:EMERGENCY ROOM
Practice Address - City:NEW HARTFORD
Practice Address - State:NY
Practice Address - Zip Code:13413-1068
Practice Address - Country:US
Practice Address - Phone:315-624-6635
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Single Specialty