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General NPI Number Information
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NPI Number | 1356431266
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Entity Type | Organization
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Legal Business Name | MICHELE N KELEHER
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Dates
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Enumeration Date | 10/13/2006
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Last Update Date | 06/23/2008
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Provider Practice Location Address
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Address Line | 13 SOUTHWOOD DR
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City | SLINGERLANDS
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State | NY
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Zip | 12159-9316
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Country | US
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Telephone | 518-439-1485
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Fax | 518-478-0850
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Provider Business Mailing Address
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Address Line | 13 SOUTHWOOD DR
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City | SLINGERLANDS
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State | NY
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Zip | 12159-9316
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Country | US
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Telephone | 518-439-1485
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Fax | 518-478-0850
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Authorized Official
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Title or Position | OWNER
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Name | MICHELE NINA KELEHER
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Credential | PT
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Telephone | 518-439-1485
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number | 002342-1
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License Number State | NY
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