Wyatt, Kelly

Wyatt, Kelly is an individual health care provider with primary practice located at 4 Bypass Rd Ste 104 , Salem NJ 08079-2053. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pulmonary Disease, Allopathic & Osteopathic Physicians / Internal Medicine. Allopathic & Osteopathic Physicians / Internal Medicine is her primary health care specialty. Wyatt, Kelly can be contacted via phone (610) 619-7460.

Contact Information

Primary practice address
4 Bypass Rd Ste 104 Salem NJ 08079-2053
Phone: (610) 619-7460
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pulmonary Disease 207RP1001X 26NJ00996800 New Jersey
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 26NJ00996800 New Jersey

Profile Details

NPI number 1033756044
LBN Legal business name Wyatt, Kelly
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 9th, 2019
Last updated Sep 7th, 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 1033756044 NPPES
New Jersey MEDICAID 1033756044

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