Individual
CRISTIN MAURA KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
390 ROUTE 10 W, SUITE 102, RANDOLPH, NJ 07869-2141
(973) 366-6303
Mailing address
136 WOODSIDE AVE, NEWTON, NJ 07860-2313
(973) 300-0555
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
25MP00337900
NJ
Other
Enumeration date
07/08/2014
Last updated
11/10/2015
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