Kelly, Stephen Patrick

Kelly, Stephen Patrick is an individual health care provider with primary practice located at 2015 Grand Concourse , Bronx NY 10453-4303. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Kelly, Stephen Patrick can be contacted via phone (718) 299-7295.

Contact Information

Primary practice address
2015 Grand Concourse Bronx NY 10453-4303
Phone: (718) 299-7295
Fax: (718) 299-6797
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 127414 New York

Profile Details

NPI number 1982675013
LBN Legal business name Kelly, Stephen Patrick
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 27th, 2006
Last updated Oct 22nd, 2021 - about 3 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 1982675013 NPPES
New York MEDICAID 00367928

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