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Organization

DESIREE D. NELSON-KELLY, DPM

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DESIREE DIANE NELSON-KELLY D.P.M. (PODIATRIST)
(732) 541-1118
Entity
Organization

Contact information

Practice address
32 TENNYSON ST, CARTERET, NJ 07008-2330
(732) 541-1118
(732) 541-2111
Mailing address
32 TENNYSON ST, CARTERET, NJ 07008-2330
(732) 541-1118
(732) 541-2111

Taxonomy

Speciality
Code
Description
License number
State
213EP1101X
Primary Podiatric Medicine Podiatrist
Primary
25MD002581
NJ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2116024
UNITED HEALTHCARE
NJ
01
2K9378
HEALTHNET
NJ
01
60009551
HORIZON NJ HEALTH
NJ
01
P3239784
OXFORD
NJ
Enumeration date
04/12/2007
Last updated
08/22/2020
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