Provider Demographics
NPI:1881030575
Name:KEENE, NILDA M (MD)
Entity type:Individual
Prefix:DR
First Name:NILDA
Middle Name:M
Last Name:KEENE
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:414 STOKES RD
Mailing Address - Street 2:STE 204
Mailing Address - City:MEDFORD
Mailing Address - State:NJ
Mailing Address - Zip Code:08055-8400
Mailing Address - Country:US
Mailing Address - Phone:609-654-4990
Mailing Address - Fax:609-654-4992
Practice Address - Street 1:414 STOKES RD
Practice Address - Street 2:STE 204
Practice Address - City:MEDFORD
Practice Address - State:NJ
Practice Address - Zip Code:08055-8400
Practice Address - Country:US
Practice Address - Phone:609-654-4990
Practice Address - Fax:609-654-4992
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-21
Last Update Date:2013-05-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MA055407002084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry