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General NPI Number Information
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NPI Number | 1699815100
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Entity Type | Individual
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Provider Name | JAMES A KELLEHER PT
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Gender | Male
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Dates
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Enumeration Date | 02/07/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 70 MANHEIM AVE SUITE 3
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City | BRIDGETON
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State | NJ
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Zip | 08302-2136
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Country | US
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Telephone | 856-455-9700
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Fax | 856-455-9791
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Provider Business Mailing Address
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Address Line | 351 CENTRAL AVE
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City | WOODBURY
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State | NJ
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Zip | 08097-1345
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Country | US
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Telephone | 856-853-2623
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Fax | 856-853-2747
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 40QA00876500
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License Number State | NJ
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