Provider Demographics
NPI:1730158130
Name:KEENE, MAURA E (MD)
Entity type:Individual
Prefix:
First Name:MAURA
Middle Name:E
Last Name:KEENE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:280 CHESTNUT ST
Mailing Address - Street 2:2ND FL
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01199-1001
Mailing Address - Country:US
Mailing Address - Phone:413-794-5700
Mailing Address - Fax:
Practice Address - Street 1:325B KING ST
Practice Address - Street 2:
Practice Address - City:NORTHAMPTON
Practice Address - State:MA
Practice Address - Zip Code:01060-2370
Practice Address - Country:US
Practice Address - Phone:413-586-2496
Practice Address - Fax:413-923-5557
Is Sole Proprietor?:No
Enumeration Date:2006-03-16
Last Update Date:2016-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA57273207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA000000007038OtherBMC
MA2623717OtherAETNA
MAA23306Medicare PIN
MA04-3194547OtherNORTH AMERICAN PREFERRED
MA057273OtherTUFTS
MA24241OtherHNE
MA04-3194547OtherNORTHEAST HEALTH DIRECT
MAJ08080OtherBCBSMA
MA04-3194547OtherPHCS
MA131143OtherHARVARD PILGRIM
MA04-3194547OtherNORTHEAST HEALTHCARE ALLI
MA3042081Medicaid
MA04-3194547OtherPLAN VISTA
MA2939906004OtherCIGNA
MA04-3194547OtherGREAT-WEST
MD04-3194547OtherUNITED HEALTH
D87908Medicare UPIN
MA04-3194547OtherCONSOLIDATED
MA04-3194547OtherUNICARE/GIC
MA057273OtherCONNECTICARE