MEDICARE: KELSEY MOORMAN DO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2080N0001X	Neonatal-Perinatal Medicine Physician	05437	KY
2	390200000X	Student in an Organized Health Care Education/Training Program

General Provider Information

NPI Number	:	1477180248
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KELSEY MOORMAN DO

Provider Business Mailing Address
First Line	:	100 MADISON AVE
Second Line	:
City	:	MORRISTOWN
State	:	NJ
Zip	:	07960-6136
Country	:	US
Telephone Number	:	973-971-5000
Fax Number	:

Provider Business Practice Location Address
First Line	:	100 MADISON AVE
Second Line	:
City	:	MORRISTOWN
State	:	NJ
Zip	:	07960-6136
Country	:	US
Telephone Number	:	973-971-5000
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/23/2020
Last Update Date	:	03/03/2026

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