Provider Demographics
NPI:1144250564
Name:KEAMY, JEAN ELIZABETH (MD)
Entity type:Individual
Prefix:MS
First Name:JEAN
Middle Name:ELIZABETH
Last Name:KEAMY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:24 LYMAN ST STE 130
Mailing Address - Street 2:
Mailing Address - City:WESTBOROUGH
Mailing Address - State:MA
Mailing Address - Zip Code:01581-1484
Mailing Address - Country:US
Mailing Address - Phone:508-836-8733
Mailing Address - Fax:508-836-3342
Practice Address - Street 1:24 LYMAN ST
Practice Address - Street 2:SUITE 130
Practice Address - City:WESTBOROUGH
Practice Address - State:MA
Practice Address - Zip Code:01581-1482
Practice Address - Country:US
Practice Address - Phone:508-836-8733
Practice Address - Fax:508-836-3342
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-03
Last Update Date:2024-06-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA204780207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0143791Medicaid
MAH46012Medicare UPIN
MAA32867Medicare ID - Type Unspecified