Laverdure, Kelly M.

Laverdure, Kelly M. is an individual health care provider with primary practice located at 750 Brunswick Ave , Trenton NJ 19178-8567. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Laverdure, Kelly M. can be contacted via phone (609) 815-7810.

Contact Information

Primary practice address
750 Brunswick Ave Trenton NJ 19178-8567
Phone: (609) 815-7810
Fax: (609) 815-7814
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X OS013010 Pennsylvania

Profile Details

NPI number 1568465656
LBN Legal business name Laverdure, Kelly M.
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date May 23rd, 2005
Last updated Aug 30th, 2012 - about 12 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 1568465656 NPPES
Pennsylvania MEDICAID 1011991960001

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