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Contact Information

EILEEN F KEANE, PNP
374 GRAND AVE
NEW HAVEN, CT06513-3733
 Phone: 203-777-7411
 Fax: 203-777-8506
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Pediatrics

363LP0200X 50 Nurse Practitioner
 

Pediatrics

163WP0200X
Indicates primary specialty

NPI Profile & details for EILEEN F KEANE · (Female)

NPI # 1962413401
Status Active
Credentials PNP
Entity Individual
Enumeration date 08/10/2006
Last updated 11/29/2018 - About 8 years ago
Sole proprietor 1 No
Identifiers
  • CT License # 006169
  • CT License # 6169
  • MA Medicaid 1300709
  • MA Other NP9903 BCBS
  • MA Other Y10141 BCBS-GROUP
  • MA Other 56780 FALLON SELECT
Hospital affiliation(s) Not Available
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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