Provider Demographics
NPI:1619134285
Name:KELLER, JULIE MICHELLE (MD)
Entity Type:Individual
Prefix:DR
First Name:JULIE
Middle Name:MICHELLE
Last Name:KELLER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:113 W ESSEX ST
Mailing Address - Street 2:SUITE 201
Mailing Address - City:MAYWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07607-1020
Mailing Address - Country:US
Mailing Address - Phone:201-226-0145
Mailing Address - Fax:201-226-0147
Practice Address - Street 1:113 W ESSEX ST
Practice Address - Street 2:SUITE 201
Practice Address - City:MAYWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07607-1020
Practice Address - Country:US
Practice Address - Phone:201-226-0145
Practice Address - Fax:201-226-0147
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-20
Last Update Date:2014-02-27
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NJ25 MA08801100207XX0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XX0801XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Trauma