Kelley, Kristine

Kelley, Kristine is an individual health care provider with primary practice located at 225 Penn Ave , Scranton PA 18503-1921. She recently has 2 registered licenses in different health care specialties including Other Service Providers / Legal Medicine, Allopathic & Osteopathic Physicians / Surgery. Allopathic & Osteopathic Physicians / Surgery is her primary health care specialty. Kelley, Kristine can be contacted via phone (570) 342-7864.

Contact Information

Primary practice address
225 Penn Ave Scranton PA 18503-1921
Phone: (570) 342-7864
Fax: (570) 342-7119
Website:
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Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Legal Medicine 173000000X MD-032146-E Pennsylvania
Allopathic & Osteopathic Physicians / Surgery 208600000X MD032146E Pennsylvania

Profile Details

NPI number 1811968621
LBN Legal business name Kelley, Kristine
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 30th, 2006
Last updated Jan 20th, 2022 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1811968621 NPPES
Pennsylvania MEDICAID 0011243520001

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