Healthcare Provider Details

I. General information

NPI: 1366236168
Provider Name (Legal Business Name): KELLIE ZEICHNER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/07/2025
Last Update Date: 04/07/2025
Certification Date: 04/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

195 LITTLE ALBANY ST
NEW BRUNSWICK NJ
08901-1914
US

IV. Provider business mailing address

195 LITTLE ALBANY ST
NEW BRUNSWICK NJ
08901-1914
US

V. Phone/Fax

Practice location:
  • Phone: 732-514-2267
  • Fax:
Mailing address:
  • Phone: 732-598-9629
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WX0200X
TaxonomyOncology Registered Nurse
License Number26NR11359400
License Number StateNJ
# 2
Primary TaxonomyY
Taxonomy Code364SG0600X
TaxonomyGerontology Clinical Nurse Specialist
License Number26NJ15128300
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: