Individual
BRYAN T KELLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
535 E 70TH ST, NEW YORK, NY 10021-4823
(212) 606-1159
(646) 797-8865
Mailing address
535 E 70TH ST, NEW YORK, NY 10021-4872
(212) 606-1159
(646) 797-8865
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
208586
NY
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
Primary
208586
NY
207XX0801X
Orthopaedic Trauma Physician
208586
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02201081
—
NY
Enumeration date
07/11/2006
Last updated
02/01/2021
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