Provider Demographics
NPI:1588661102
Name:KELLY, JOSEPH PATRICK (PT)
Entity Type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:PATRICK
Last Name:KELLY
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:433 OLD RIVER RD
Mailing Address - Street 2:
Mailing Address - City:MAYS LANDING
Mailing Address - State:NJ
Mailing Address - Zip Code:08330-1610
Mailing Address - Country:US
Mailing Address - Phone:609-625-9585
Mailing Address - Fax:
Practice Address - Street 1:1801 N ROUTE 9
Practice Address - Street 2:HOLY REDEEMER HEALTH SYSTEMS
Practice Address - City:CAPE MAY COURT HOUSE
Practice Address - State:NJ
Practice Address - Zip Code:08210-1436
Practice Address - Country:US
Practice Address - Phone:609-463-6071
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-06-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJQA03248225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist