MEDICARE: ELIZABETH LEPINNET KELLY PT, DPT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	027320	NY

General Provider Information

NPI Number	:	1487601852
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELIZABETH LEPINNET KELLY PT, DPT

Provider Business Mailing Address
First Line	:	51 ELM STREET
Second Line	:
City	:	DELHI
State	:	NY
Zip	:	13753
Country	:	US
Telephone Number	:	607-746-7835
Fax Number	:

Provider Business Practice Location Address
First Line	:	51 ELM ST
Second Line	:
City	:	DELHI
State	:	NY
Zip	:	13753-1208
Country	:	US
Telephone Number	:	607-746-7835
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/30/2006
Last Update Date	:	03/15/2013

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