Individual
JOHN MICHAEL KELLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2211 GENESEE ST, UTICA, NY 13501-5930
(315) 733-7798
(315) 733-7893
Mailing address
1 ATWELL RD, COOPERSTOWN, NY 13326-1301
(607) 547-4770
(607) 547-7891
Taxonomy
Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
190295-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01489990
—
NY
Enumeration date
05/27/2006
Last updated
04/02/2013
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