Individual
GRANT GORDON KELLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
301 PROSPECT AVE, HOSPITAL INTERNISTS, SYRACUSE, NY 13203-1807
(315) 448-5704
(315) 423-6853
Mailing address
301 PROSPECT AVE, HOSPITAL INTERNISTS, SYRACUSE, NY 13203-1807
(315) 448-5704
(315) 423-6853
Taxonomy
Speciality
Code
Description
License number
State
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
205703
NY
208M00000X
Hospitalist Physician
Primary
205703
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01724529
—
NY
Enumeration date
10/09/2008
Last updated
07/12/2010
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