Individual
KELLEY WACHTER MALI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
50 NEWARK AVE, SUITE 205, BELLEVILLE, NJ 07109-1185
(973) 429-2209
Mailing address
72 YORKSHIRE DR, CEDAR GROVE, NJ 07009-2036
(908) 399-3506
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
25MP00280600
NJ
Other
Enumeration date
05/01/2012
Last updated
09/20/2017
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