Provider Demographics
NPI:1063404226
Name:HENRY KEYS MD, PLLC
Entity type:Organization
Organization Name:HENRY KEYS MD, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HENRY
Authorized Official - Middle Name:
Authorized Official - Last Name:KEYS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:607-431-5475
Mailing Address - Street 1:PO BOX 8510
Mailing Address - Street 2:HENRY KEYS MD
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12208-0510
Mailing Address - Country:US
Mailing Address - Phone:607-431-5475
Mailing Address - Fax:
Practice Address - Street 1:1 FOX CARE DR
Practice Address - Street 2:SUITE 310
Practice Address - City:ONEONTA
Practice Address - State:NY
Practice Address - Zip Code:13820-2086
Practice Address - Country:US
Practice Address - Phone:607-431-5475
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-15
Last Update Date:2009-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation OncologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYAA1192Medicare ID - Type UnspecifiedGROUP MEDICARE NUMBER