Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0131X | Foot Surgery | MD01285 | NJ |
NPI | 1043373384 |
---|---|
Provider Name | William Scott Kelley |
First Address | Ramsey, NJ 07446-2549 |
Second Address | Ramsey, NJ 07446-2549 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/12/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1743601 | (05) | NJ |
U26974 | (02) | NJ |