Organization
PAUL MITCHELL KELLEHER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PAUL MITCHELL KELLEHER D.O. (PHYSICIAN)
(717) 818-3167
Entity
Organization
Contact information
Practice address
4434 AMBOY RD, STATEN ISLAND, NY 10312-3866
(718) 227-7015
Mailing address
49 W RAYBURN RD, MILLINGTON, NJ 07946-1502
(908) 542-1792
Taxonomy
Speciality
Code
Description
License number
State
2081S0010X
Sports Medicine (Physical Medicine & Rehabilitation) Physician
Primary
206597
NY
Other
Enumeration date
05/30/2007
Last updated
08/22/2020
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