Dr KEITH A CHRISTIANSEN is a male medical professional, specializing in Urology. He graduated in 2005 from Georgetown University Of Medicine.
SOVEREIGN MEDICAL GROUP LLC
14 -01 BROADWAY
SUITE 3
FAIR LAWN
NJ
074102008
Tel: 2017914544
| Npi | 1679724694 |
| Pac Id | 5395917488 |
| Professional Enrollment Id | I20111014000203 |
| Last Name | CHRISTIANSEN |
| First Name | KEITH |
| Middle Name | A |
| Suffix | |
| Gender | M |
| Credential | |
| Medical School Name | GEORGETOWN UNIVERSITY OF MEDICINE |
| Graduation Year | 2005 |
| Primary Specialty | UROLOGY |
| Secondary Specialty 1 | |
| Secondary Specialty 2 | |
| Secondary Specialty 3 | |
| Secondary Specialty 4 | |
| All Secondary Specialties | |
| Organization Legal Name | SOVEREIGN MEDICAL GROUP LLC |
| Group Practice Pac Id | 1456535392 |
| Number Of Group Practice Members | 46 |
| Line 1 Street Address | 14 -01 BROADWAY |
| Line 2 Street Address | SUITE 3 |
| Marker Of Address Line 2 Suppression | |
| City | FAIR LAWN |
| State | NJ |
| Zip Code | 074102008 |
| Phone Number | 2017914544 |
| Hospital Affiliation Ccn 1 | 310019 |
| Hospital Affiliation Lbn 1 | ST JOSEPH'S HOSPITAL AND MEDICAL CENTER |
| Hospital Affiliation Ccn 2 | 310001 |
| Hospital Affiliation Lbn 2 | HACKENSACK UNIVERSITY MEDICAL CENTER |
| Hospital Affiliation Ccn 3 | 310012 |
| Hospital Affiliation Lbn 3 | VALLEY HOSPITAL |
| Hospital Affiliation Ccn 4 | |
| Hospital Affiliation Lbn 4 | |
| Hospital Affiliation Ccn 5 | |
| Hospital Affiliation Lbn 5 | |
| Professional Accepts Medicare Assignment | Y |
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