| Doctor Name: | MRS. ANASTASIA KEISIDIS |
| NPI Number: | 1346519113 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | R.N. |
| License Number: | 455357 |
| Business Practice Address: | 139 Fairbanks Rd Churchville, NY - 144289782 |
| Business Phone Number: | 5852934541 |
| Business Fax Number: | 5852934513 |
| Mailing Address: | 3 Town Pump Cir, SPENCERPORT |
| State: | NY |
| Postal Code: | 145599734 |
| Phone Number: | 5855943155 |
| Fax Number: | |
| NPI Enumeration Date: | 12/22/2011 |
| NPI Last Update Date: | 12/22/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 163WS0200X |
| License Number: | 455357 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Nursing Service Providers |
| Taxonomy Classification: | Registered Nurse |
| Taxonomy Specialization: | School |
| Taxonomy Definition: | |