Dr. Sean R. Kelly
Physical Medicine & Rehabilitation Doctor Sports Medicine
4747 Main St
Bridgeport
, Connecticut 06606-1804
Dr. Sean R. Kelly
Physical Medicine & Rehabilitation Doctor Sports Medicine
4747 Main St
Bridgeport
, Connecticut 06606-1804
(203) 373-0376
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About
Features
Specialties
- Physical Medicine & Rehabilitation Doctor
- Sports Medicine
Languages spoken
- English
Location
First Address
- Dr. Sean R. Kelly
- 4747 Main St
- Bridgeport, CT
- Zip : 06606-1804
- Fax : (203) 373-0376
- Phone : (203) 372-0649
Second Address
- Dr. Sean R. Kelly
- 4747 Main St
- Bridgeport, CT
- Zip : 06606-1804
- Fax : (203) 373-0376
- Phone : (203) 372-0649
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 208100000X | Physical Medicine & Rehabilitation Doctor | 045878 | CT |
| N | 2081S0010X | Sports Medicine | 045878 | CT |
| N | 213ES0000X | Sports Medicine | 045878 | CT |
National Provider Identifier
| NPI | 1083685705 |
|---|---|
| Provider Name | Dr. Sean R. Kelly |
| First Address | Bridgeport, CT 06606-1804 |
| Second Address | Bridgeport, CT 06606-1804 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 31/01/2006 |
| Last Update Date | 19/03/2019 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| VAD000 | (02) |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.