Provider Demographics
NPI:1780839068
Name:MCKEEVER, NICOLETTA SUZAN (MSPT)
Entity type:Individual
Prefix:MRS
First Name:NICOLETTA
Middle Name:SUZAN
Last Name:MCKEEVER
Suffix:
Gender:F
Credentials:MSPT
Other - Prefix:MISS
Other - First Name:NICOLETTA
Other - Middle Name:SUZAN
Other - Last Name:LISA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:6606 VETERANS AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11234-5720
Mailing Address - Country:US
Mailing Address - Phone:646-207-0536
Mailing Address - Fax:718-531-7981
Practice Address - Street 1:6606 VETERANS AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11234-5720
Practice Address - Country:US
Practice Address - Phone:646-207-0536
Practice Address - Fax:718-531-7981
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-30
Last Update Date:2008-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist