Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NN0400X | Neurology | 38MC00193100 | NJ |
NPI | 1922176700 |
---|---|
Provider Name | Dr. Art Kellenberger |
First Address | Clinton, NJ 08809-1209 |
Second Address | Clinton, NJ 08809-1209 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/12/2006 |
Last Update Date | 04/06/2013 |