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General NPI Number Information
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NPI Number | 1972567576
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Entity Type | Individual
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Provider Name | JAY JOEL KELINSON M.D.
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Gender | Male
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Dates
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Enumeration Date | 04/12/2006
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Last Update Date | 07/11/2007
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Provider Practice Location Address
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Address Line | 177 NORTH DEAN STREET #208
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City | ENGLEWOOD
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State | NJ
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Zip | 07631
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Country | US
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Telephone | 201-569-0200
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Fax |
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Provider Business Mailing Address
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Address Line | 177 N DEAN ST #208
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City | ENGLEWOOD
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State | NJ
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Zip | 07631-2533
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Country | US
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Telephone | 978-621-7493
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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 | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 25MA08164900
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License Number State | NJ
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