Kelly, Jennifer J

Kelly, Jennifer J is an individual health care provider with primary practice located at 62 Tilley Dr Ste 202 , South Burlington VT 05403-4407. She recently has only one registered license in Allopathic & Osteopathic Physicians / Endocrinology, Diabetes & Metabolism, which is considered as her primary health care specialty. Kelly, Jennifer J can be contacted via phone (802) 847-4576.

Contact Information

Primary practice address
62 Tilley Dr Ste 202 South Burlington VT 05403-4407
Phone: (802) 847-4576
Fax: (802) 847-4967
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Endocrinology, Diabetes & Metabolism 207RE0101X 216420 New York
Allopathic & Osteopathic Physicians / Endocrinology, Diabetes & Metabolism 207RE0101X 032.0129312 Vermont

Profile Details

NPI number 1104867779
LBN Legal business name Kelly, Jennifer J
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 8th, 2006
Last updated Jan 3rd, 2024 - about last year

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 1104867779 NPPES
New York MEDICAID 02532745

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