Provider Demographics
NPI:1407912694
Name:KELLY, JANINE SCHRENZEL (MD)
Entity Type:Individual
Prefix:DR
First Name:JANINE
Middle Name:SCHRENZEL
Last Name:KELLY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:755 N BROADWAY
Mailing Address - Street 2:SUITE 100
Mailing Address - City:SLEEPY HOLLOW
Mailing Address - State:NY
Mailing Address - Zip Code:10591-1075
Mailing Address - Country:US
Mailing Address - Phone:914-366-3677
Mailing Address - Fax:
Practice Address - Street 1:755 N BROADWAY
Practice Address - Street 2:SUITE 100
Practice Address - City:SLEEPY HOLLOW
Practice Address - State:NY
Practice Address - Zip Code:10591-1075
Practice Address - Country:US
Practice Address - Phone:914-366-3677
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-29
Last Update Date:2011-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY159488-1207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYA400010715Medicare PIN
NYF21005Medicare UPIN