Healthcare Provider Details

I. General information

NPI: 1962290163
Provider Name (Legal Business Name): KELLY TURCIOS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/28/2025
Last Update Date: 04/28/2025
Certification Date: 04/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

303 GEORGE ST FL 2
NEW BRUNSWICK NJ
08901-2020
US

IV. Provider business mailing address

671 HOES LN W
PISCATAWAY NJ
08854-8021
US

V. Phone/Fax

Practice location:
  • Phone: 732-235-6800
  • Fax:
Mailing address:
  • Phone: 908-587-8449
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number44SL07122800
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: