MEDICARE: RENA KELMAN

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	1041C0700X	Clinical Social Worker	079965-1	NY

General Provider Information

NPI Number	:	1609129972
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RENA KELMAN

Provider Business Mailing Address
First Line	:	3116 AVENUE M
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11210-4747
Country	:	US
Telephone Number	:	718-258-0182
Fax Number	:

Provider Business Practice Location Address
First Line	:	3116 AVENUE M
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11210-4747
Country	:	US
Telephone Number	:	171-825-8018
Fax Number	:

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

Provider Enumeration Date	:	10/23/2012
Last Update Date	:	10/23/2012

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Directions to “ RENA KELMAN ” Practice Location

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