Individual
KELLI A WARGO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
909 WALNUT ST, 2ND FLOOR, PHILADELPHIA, PA 19107
(215) 955-7000
Mailing address
501 E 74TH ST APT 7B, NEW YORK, NY 10021-3698
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
011507-1
NY
363A00000X
Physician Assistant
MA052944
NJ
363A00000X
Physician Assistant
Primary
MA052944
PA
Other
Enumeration date
05/25/2007
Last updated
08/02/2018
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