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General NPI Number Information
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NPI Number | 1184655375
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Entity Type | Individual
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Provider Name | ANNA B KELLY MD
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Gender | Female
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Dates
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Enumeration Date | 07/05/2006
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Last Update Date | 02/03/2021
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Provider Practice Location Address
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Address Line | 81 E CLINTON AVE
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City | TENAFLY
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State | NJ
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Zip | 07670-2102
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Country | US
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Telephone | 201-233-5726
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Fax |
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Provider Business Mailing Address
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Address Line | 81 E CLINTON AVE
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City | TENAFLY
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State | NJ
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Zip | 07670-2102
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Country | US
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Telephone | 201-233-5726
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085N0700X
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Taxonomy Name | Neuroradiology Physician
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License Number | 154584-1
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 154584-1
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | MA52932
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License Number State | NJ
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