Healthcare Provider Details

I. General information

NPI: 1538686241
Provider Name (Legal Business Name): KELSEY POMEROY PA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KELSEY SCHROEDER

II. Dates (important events)

Enumeration Date: 08/23/2017
Last Update Date: 07/06/2026
Certification Date: 07/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

217 WHITE HORSE PIKE
HADDON HEIGHTS NJ
08035-1703
US

IV. Provider business mailing address

301 LIPPINCOTT DR STE 410
MARLTON NJ
08053-4197
US

V. Phone/Fax

Practice location:
  • Phone: 856-547-1212
  • Fax: 856-547-3722
Mailing address:
  • Phone: 609-267-9400
  • Fax: 609-927-1616

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number25MP00451700
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: