Individual
SHAREEN F. KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
3601 A ST, PHILADELPHIA, PA 19134-1043
(215) 427-4815
(215) 427-4637
Mailing address
6122 N 6TH ST, PHILADELPHIA, PA 19120-1321
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
MD050539-L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0014897740010
—
PA
Enumeration date
05/17/2006
Last updated
01/08/2014
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