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NPI Code Detail

MEDICARE: ELLEN KELLY M.S.

MEDICARE:   ELLEN  KELLY  M.S.
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
1237600000XAudiologist-Hearing Aid Fitter27NJ

General Provider Information

NPI Number : 1548310055
Entity Type Code : Individual
Provider Name (Legal Business Name) : ELLEN KELLY M.S.
Provider Business Mailing Address
First Line : 11 KENSINGTON CT
Second Line :
City : ASBURY
State : NJ
Zip : 08802-1100
Country : US
Telephone Number : 908-735-7123
Fax Number :
Provider Business Practice Location Address
First Line : 44 MILLTOWN RD
Second Line :
City : EAST BRUNSWICK
State : NJ
Zip : 08816-2356
Country : US
Telephone Number : 732-238-1664
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/10/2007
Last Update Date : 05/12/2008

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