Individual
DR. ROY A KELLERMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
35 JOLLEY DR STE 201, BLOOMFIELD, CT 06002-4228
(860) 243-5569
(860) 243-2622
Mailing address
35 JOLLEY DR STE 201, BLOOMFIELD, CT 06002-4228
(860) 243-5569
(860) 243-2622
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
23862
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001238625
—
CT
01
—
010023862CT05
BLUE CROSS
CT
01
—
73169936
CONNECTICARE
CT
Enumeration date
11/27/2006
Last updated
06/16/2021
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