Provider Demographics
NPI:1366206492
Name:KEEN NEUROPHYSIOLOGY LLC
Entity type:Organization
Organization Name:KEEN NEUROPHYSIOLOGY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:ALEXANDRA
Authorized Official - Middle Name:
Authorized Official - Last Name:CARRER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:908-900-4589
Mailing Address - Street 1:55 MADISON AVE STE 400
Mailing Address - Street 2:
Mailing Address - City:MORRISTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07960-7397
Mailing Address - Country:US
Mailing Address - Phone:908-315-0469
Mailing Address - Fax:908-900-4615
Practice Address - Street 1:55 MADISON AVE STE 400
Practice Address - Street 2:
Practice Address - City:MORRISTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07960-7397
Practice Address - Country:US
Practice Address - Phone:908-900-4615
Practice Address - Fax:908-315-0469
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-08
Last Update Date:2024-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty