Provider Demographics
NPI:1013228386
Name:MCELROY, KEVIN (DO)
Entity Type:Individual
Prefix:DR
First Name:KEVIN
Middle Name:
Last Name:MCELROY
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:48 S FRANKLIN TPKE
Mailing Address - Street 2:STE 101
Mailing Address - City:RAMSEY
Mailing Address - State:NJ
Mailing Address - Zip Code:07446-2558
Mailing Address - Country:US
Mailing Address - Phone:201-962-9199
Mailing Address - Fax:201-962-9198
Practice Address - Street 1:48 S FRANKLIN TPKE
Practice Address - Street 2:SUITE 101
Practice Address - City:RAMSEY
Practice Address - State:NJ
Practice Address - Zip Code:07446-2558
Practice Address - Country:US
Practice Address - Phone:201-632-3080
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-01
Last Update Date:2016-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MB087709002081P2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain Medicine