Individual
KETTELY JOSEPH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
2015 GRAND AVE, BRONX, NY 10453-4611
(718) 583-7736
(718) 537-6180
Mailing address
2626 HALPERIN AVE, BRONX, NY 10461-2631
(718) 618-0401
(347) 479-1303
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
F432622
NY
363LC0200X
Critical Care Medicine Nurse Practitioner
11023636
FL
Other
Enumeration date
12/27/2022
Last updated
04/22/2024
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