Kelly, James

Kelly, James is an individual health care provider with primary practice located at 7035 113Th St , Forest Hills NY 11375-4651. He recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Medical, Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant. Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant is his primary health care specialty. Kelly, James can be contacted via phone (718) 990-4648.

Contact Information

Primary practice address
7035 113Th St Forest Hills NY 11375-4651
Phone: (718) 990-4648
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X 003867 New York
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 003867 New York

Profile Details

NPI number 1902840549
LBN Legal business name Kelly, James
Credentials Physician Assistant (PA)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 15th, 2006
Last updated Apr 12th, 2018 - about 6 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 1902840549 NPPES
New York MEDICAID 01638059

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