Diana Keddis

NPI #1447734330 in Staten Island, New York

Provider Information

NPI Number: 1447734330
Entity Type: Individual
Name: Diana Keddis
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Pharmacy
Enumeration Date: Sep 18, 2018
Last Updated: Sep 18, 2018

Practice Location

Address: 252 PORT RICHMOND AVE STE B
City: Staten Island
State: New York
ZIP Code: 10302-1740
Phone: (718) 556-0942

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Pharmacy	333600000X	Primary

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