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General NPI Number Information
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NPI Number | 1730504812
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Entity Type | Individual
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Provider Name | JENNIFER S KELLY PHARMD, BCPS
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Gender | Female
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Dates
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Enumeration Date | 02/25/2014
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Last Update Date | 06/02/2016
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Provider Practice Location Address
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Address Line | 900 WASHINGTON RD
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City | WEST POINT
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State | NY
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Zip | 10996-1109
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Country | US
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Telephone | 845-938-6069
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Fax |
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Provider Business Mailing Address
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Address Line | 495 S COOKS BRIDGE RD
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City | JACKSON
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State | NJ
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Zip | 08527-2968
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Country | US
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Telephone | 732-267-4811
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 28RI03504000
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 1835P1200X
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Taxonomy Name | Pharmacotherapy Pharmacist
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License Number | 3130977
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License Number State | NJ
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Taxonomy #3
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Taxonomy Code | 1835P0018X
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Taxonomy Name | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
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License Number | 28RI03504000
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License Number State | NJ
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