Healthcare Provider Details

I. General information

NPI: 1801729199
Provider Name (Legal Business Name): KELLY ELEANOR CARR DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/05/2026
Last Update Date: 06/05/2026
Certification Date: 05/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

610 OCEAN AVENUE
LONG BRANCH NJ
07740
US

IV. Provider business mailing address

1500 MEETING HOUSE RD
SEA GIRT NJ
08750-2220
US

V. Phone/Fax

Practice location:
  • Phone: 732-795-6770
  • Fax: 848-275-2279
Mailing address:
  • Phone: 732-784-6545
  • Fax: 732-240-5280

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number40QA02419200
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: