Healthcare Provider Details

I. General information

NPI: 1295614345
Provider Name (Legal Business Name): KELLY PERKOWSKI APN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/01/2025
Last Update Date: 06/03/2026
Certification Date: 06/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2163 OAK TREE RD STE 210
EDISON NJ
08820-1083
US

IV. Provider business mailing address

331 NEWMAN SPRINGS RD STE 220
RED BANK NJ
07701-5792
US

V. Phone/Fax

Practice location:
  • Phone: 908-561-9500
  • Fax: 908-561-7162
Mailing address:
  • Phone: 732-807-0877
  • Fax: 201-751-1680

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number26NJ15410000
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: