Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VX0201X | Gynecologic Oncologist | MD037151E | PA |
NPI | 1558335745 |
---|---|
Provider Name | Dr. Joseph Leo Kelley |
First Address | Pittsburgh, PA 15213-3108 |
Second Address | Pittsburgh, PA 15213-3108 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/02/2006 |
Last Update Date | 19/06/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
001257896 | (05) | PA |
E39478 | (02) | PA |