Provider Demographics
NPI:1174709315
Name:KEHOE, ELEANOR MARIE (PNP, PHD)
Entity type:Individual
Prefix:DR
First Name:ELEANOR
Middle Name:MARIE
Last Name:KEHOE
Suffix:
Gender:F
Credentials:PNP, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8740 25TH AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11214-5402
Mailing Address - Country:US
Mailing Address - Phone:718-372-3600
Mailing Address - Fax:
Practice Address - Street 1:8740 25TH AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11214-5402
Practice Address - Country:US
Practice Address - Phone:718-372-3600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-17
Last Update Date:2008-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF380821363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics