Individual
DR. KURT P. MICELI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
111 ELWYN RD, ELWYN, PA 19063-4622
(610) 891-7385
Mailing address
1255 CALDWELL RD, CHERRY HILL, NJ 08034-3220
(856) 324-3256
(856) 667-1281
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
MD442574
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1316155450
—
VA
Enumeration date
05/21/2007
Last updated
01/06/2020
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