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Contact Information

KEITH A CHADWICK, MD, MS
4 SMITH HAVEN MALL STE 200
LAKE GROVE, NY11755-1219
 Phone: 631-444-4121
 Fax: 631-444-4189
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Otolaryngology

207Y00000X 04 Physician/Otolaryngology
 

Student in an Organized Health Care Education/Training Program

390200000X
Indicates primary specialty

NPI Profile & details for KEITH A CHADWICK · (Male)

NPI Number 1487091328
Status Active
Credentials MD, MS
Entity Individual
Enumeration date 06/02/2013
Last updated 02/15/2026 - About 4 months ago
Sole proprietor 1 No
Identifiers
  • NY License # 294203
  • OR License # PG168015
  • VA License # 0116025714
Hospital affiliation(s)
  • UNIVERSITY HOSPITAL ( STONY BROOK ) - (Acute Care)
    HEALTH SCIENCES CENTER SUNY
    STONY BROOK, NY 11794
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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