Healthcare Provider Details

I. General information

NPI: 1497755532
Provider Name (Legal Business Name): WHITEHOUSE STATION FAMILY MEDICINE, P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/29/2005
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

263 MAIN ST BOX 128
WHITEHOUSE STATION NJ
08889-3620
US

IV. Provider business mailing address

263 MAIN ST BOX 128
WHITEHOUSE STATION NJ
08889-3620
US

V. Phone/Fax

Practice location:
  • Phone: 908-534-2249
  • Fax: 908-534-6634
Mailing address:
  • Phone: 908-534-2249
  • Fax: 908-534-6634

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number StateNJ

VIII. Authorized Official

Name: DR. ALAN KELSEY
Title or Position: MD
Credential: MD
Phone: 908-534-2249