Healthcare Provider Details

I. General information

NPI: 1891125449
Provider Name (Legal Business Name): MORRIS KELLMAN PT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/18/2013
Last Update Date: 08/19/2026
Certification Date: 08/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

35 ALGONQUIN DR
STONY POINT NY
10980-3454
US

IV. Provider business mailing address

35 ALGONQUIN DR
STONY POINT NY
10980-3454
US

V. Phone/Fax

Practice location:
  • Phone: 718-473-9797
  • Fax:
Mailing address:
  • Phone: 718-473-9797
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License Number14159
License Number StateMN
# 2
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License Number070029553
License Number StateIL
# 3
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License Number40QA02323300
License Number StateNJ
# 4
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number037160
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: