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General NPI Number Information
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NPI Number | 1821221300
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Entity Type | Individual
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Provider Name | STANISLAV KELNER M.D.
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Gender | Male
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Dates
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Enumeration Date | 08/31/2009
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Last Update Date | 02/27/2020
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Provider Practice Location Address
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Address Line | 1500 LANSDOWNE AVE
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City | DARBY
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State | PA
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Zip | 19023-1200
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Country | US
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Telephone | 224-628-9238
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Fax |
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Provider Business Mailing Address
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Address Line | 429 DALMAS AVE
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City | FOLCROFT
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State | PA
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Zip | 19032-1217
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Country | US
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Telephone |
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | MT194433
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | ME140876
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License Number State | FL
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