Provider Demographics
NPI:1467536383
Name:KIELY, JAMES MARK (MD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:MARK
Last Name:KIELY
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:161 FORT WASHINGTON AVE FL 8
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10032-3729
Mailing Address - Country:US
Mailing Address - Phone:212-342-1155
Mailing Address - Fax:212-305-0267
Practice Address - Street 1:161 FORT WASHINGTON AVE FL 10
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10032-3729
Practice Address - Country:US
Practice Address - Phone:212-305-1155
Practice Address - Fax:212-305-0267
Is Sole Proprietor?:No
Enumeration Date:2006-10-25
Last Update Date:2018-04-20
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY290222208C00000X
MA249880208C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208C00000XAllopathic & Osteopathic PhysiciansColon & Rectal Surgery