Individual
JANE M GRANT-KELS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
263 FARMINGTON AVE, FARMINGTON, CT 06030-0001
(860) 679-4600
(860) 679-1248
Mailing address
65 KANE ST, WEST HARTFORD, CT 06119-2110
(860) 523-6421
(860) 523-3021
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
021687
CT
207N00000X
Dermatology Physician
ME132882
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
101119600
—
FL
Enumeration date
06/17/2005
Last updated
09/29/2022
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