Dr William Lawrence Keough, MD | |
529 Main St Ste 500, Boston, MA 02129-1122 | |
(857) 301-0143 | |
Not Available |
Full Name | Dr William Lawrence Keough |
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Gender | Male |
Speciality | Pediatrics |
Location | 529 Main St Ste 500, Boston, Massachusetts |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1811080013 | NPI | - | NPPES |
2750661 | Medicaid | OH | |
38100091110 | Medicaid | WV | |
1019202420001 | Medicaid | PA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208000000X | Pediatrics | 289808 (Massachusetts) | Secondary |
208000000X | Pediatrics | MD417522 (Pennsylvania) | Primary |
Entity Name | Childrens Health Care Associates Inc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1598869059 PECOS PAC ID: 1355253527 Enrollment ID: O20040216001108 |
Mailing Address | Practice Location Address |
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Dr William Lawrence Keough, MD 136 Muirfield Dr, Pittsburgh, PA 15229-2928 Ph: (717) 657-1957 | Dr William Lawrence Keough, MD 529 Main St Ste 500, Boston, MA 02129-1122 Ph: (857) 301-0143 |
Puja Banka, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 300 Longwood Ave, Bader 203, Boston, MA 02115 Phone: 617-355-6363 | |
Angela M. Jacques, MD Pediatrics Medicare: Medicare Enrolled Practice Location: Massachusetts General Hospital, 55 Fruit St., Boston, MA 02114 Phone: 617-726-2066 | |
Dr. Elizabeth S Taglauer, M.D., PH.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 300 Longwood Ave, Boston, MA 02115 Phone: 617-355-6000 | |
Cailyn Hereen Rood, MD Pediatrics Medicare: Accepting Medicare Assignments Practice Location: 300 Longwood Ave, Boston, MA 02115 Phone: 617-355-6000 | |
Dr. Alon Peltz, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 300 Longwood Ave, Boston, MA 02115 Phone: 617-355-6000 | |
Miki Nishitani, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 300 Longwood Ave, Boston, MA 02115 Phone: 617-355-6000 | |
Vickren Pillay, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 300 Longwood Ave, Boston, MA 02115 Phone: 617-355-6000 |