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Individual
THOMAS J KELLY
Active
Individual
THOMAS J KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
G073741
CA
2085R0202X
Diagnostic Radiology Physician
Primary
MA53386
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10540392
IHG/HEALTHSMART
CA
05
—
1760421432
—
CA
05
—
5519004
—
NJ
01
—
P01603268
RAILROAD
CA
Enumeration date
06/06/2006
Last updated
08/28/2017
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