Individual
GABRIELLA KELLISH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
23 BRUSH HILL RD, KINNELON, NJ 07405-2421
(973) 489-7884
Mailing address
PO BOX 110319, NUTLEY, NJ 07110-0906
(973) 489-7884
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
0450001066
NJ
Other
Enumeration date
08/13/2015
Last updated
11/01/2024
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