Individual
KELLY P KNOWLES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
159 MILLBURN AVE, STE 1, MILLBURN, NJ 07041-1849
(973) 912-0155
(973) 912-8714
Mailing address
159 MILLBURN AVE, STE 1, MILLBURN, NJ 07041-1849
(973) 912-0155
(973) 912-8714
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
25MA06821100
NJ
2080A0000X
Pediatric Adolescent Medicine Physician
25MA06821100
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001427892
HIGH MARK PA BLUE SHIELD
NJ
01
—
010068211NJ01
ANTHEM HEALTH PIN
NJ
01
—
0501095
AETNA HMO GRP ID
NJ
01
—
1997280
UNITED HEALTH CARE PIN
NJ
01
—
1K7604
HEALTHNET PIN
NJ
01
—
2113135000
AMERIHEALTH HMO PIN
NJ
01
—
223285437
BEECH ST GRP ID
NJ
01
—
2532962
AETNA HMO PIN
NJ
01
—
4102R
WELL CHOICE PIN
NJ
01
—
606914
PHCS GRP ID
NJ
01
—
7182328007
CIGNA PIN
NJ
01
—
956005
AMERIHEALTH PPO GRP PIN
NJ
01
—
K4810
BCBS MANAGED CARE PIN
NJ
01
—
P2075112
OXFORD PIN
NJ
Enumeration date
01/11/2006
Last updated
01/02/2013
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