Provider Demographics
NPI:1295154730
Name:CEUS, MCKIRVEN (MD)
Entity type:Individual
Prefix:
First Name:MCKIRVEN
Middle Name:
Last Name:CEUS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:162 E ROUTE 59
Mailing Address - Street 2:
Mailing Address - City:NANUET
Mailing Address - State:NY
Mailing Address - Zip Code:10954-2910
Mailing Address - Country:US
Mailing Address - Phone:845-579-2700
Mailing Address - Fax:845-259-1904
Practice Address - Street 1:162 E ROUTE 59
Practice Address - Street 2:
Practice Address - City:NANUET
Practice Address - State:NY
Practice Address - Zip Code:10954-2910
Practice Address - Country:US
Practice Address - Phone:845-579-2700
Practice Address - Fax:845-259-1904
Is Sole Proprietor?:No
Enumeration Date:2014-04-14
Last Update Date:2025-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY293059207QS0010X, 207QS0010X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QS0010XAllopathic & Osteopathic PhysiciansFamily MedicineSports Medicine