Individual
DR. DYLAN SEAN KELLOGG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
600 ROE AVE, ELMIRA, NY 14905-1629
(607) 737-4508
Mailing address
571 SAINT JOSEPHS BLVD, 2ND FLOOR, ELMIRA, NY 14901-3230
(607) 271-2050
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
282011-1
NY
207P00000X
Emergency Medicine Physician
D0080519
MD
207P00000X
Emergency Medicine Physician
P28056
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04390736
—
NY
Enumeration date
03/23/2012
Last updated
10/13/2016
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