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Individual

MRS. ANNE GERISE KELLY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PT

Contact information

Practice address
90 WEST AFTON AVE, SUITE G 5 AND 6, YARDLEY, PA 19067
(215) 493-2666
(215) 493-6639
Mailing address
8 GRENLOCH DR, TITUSVILLE, NJ 08560-1114
(609) 466-2071

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT016085
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
001682843
HIGHMARK BLUESHIELD
PA
05
1011197760001
PA
01
2356289000
IBC
PA
Enumeration date
03/03/2006
Last updated
10/11/2019
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