Individual
MR. TIMOTHY PATRICK KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNP
Contact information
Practice address
26 HIGHWAY 35 N, NEPTUNE, NJ 07753-4743
(732) 456-7777
Mailing address
1580 LAKEWOOD RD STE 16A, TOMS RIVER, NJ 08755-3287
(732) 456-7777
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
SP024404
PA
Other
Enumeration date
09/23/2021
Last updated
09/23/2021
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