Kelly, Johanna
Kelly, Johanna is an individual health care provider with primary practice located at 40 Berkshire Ct , Wyomissing PA 19610-1224. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as her primary health care specialty. Kelly, Johanna can be contacted via phone (610) 374-7400.Contact Information
Primary practice address
40 Berkshire Ct
Wyomissing PA 19610-1224
Phone: (610) 374-7400
Fax: (610) 374-4252
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | MD063346L | Pennsylvania |
Profile Details
| NPI number | 1861454159 |
|---|---|
| LBN Legal business name | Kelly, Johanna |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Apr 4th, 2006 |
| Last updated | Aug 12th, 2010 - about 14 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1861454159 | NPPES |
| Pennsylvania | MEDICAID | 1661845 |
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