Kelling, Timothy S

Kelling, Timothy S is an individual health care provider with primary practice located at 4 Fairfield Dr , Queensbury NY 12804-1514. He recently has 2 registered licenses in different health care specialties including Dental Providers / Dentist, Other Service Providers / Specialist. Other Service Providers / Specialist is his primary health care specialty. Kelling, Timothy S can be contacted via phone (518) 793-9424.

Contact Information

Primary practice address
4 Fairfield Dr Queensbury NY 12804-1514
Phone: (518) 793-9424
Fax: (518) 793-9441
Website:
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Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Dentist 122300000X 0487231 New York
Other Service Providers / Specialist 174400000X 2278311 New York

Profile Details

NPI number 1821012881
LBN Legal business name Kelling, Timothy S
Credentials D.D.S, M.D
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 26th, 2006
Last updated Mar 28th, 2016 - about 9 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 1821012881 NPPES
New York MEDICAID 02348676
New York MEDICAID 02567155

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