Kelly, Gerald

Kelly, Gerald is an individual health care provider with primary practice located at 181 N Belle Mead Rd , East Setauket NY 11733-3495. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Kelly, Gerald can be contacted via phone (111) 111-1111.

Contact Information

Primary practice address
181 N Belle Mead Rd East Setauket NY 11733-3495
Phone: (111) 111-1111
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 197099 New York

Profile Details

NPI number 1659308492
LBN Legal business name Kelly, Gerald
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 27th, 2006
Last updated Sep 29th, 2021 - about 4 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 1659308492 NPPES
New York Other 5932405 AETNA
New York MEDICAID 01654411 AETNA
New York Other 650571 AETNA

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