Provider Demographics
NPI:1649583618
Name:KELLNER, DANIEL (PHARM D)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:
Last Name:KELLNER
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23 ARLENE CT
Mailing Address - Street 2:
Mailing Address - City:MONMOUTH JUNCTION
Mailing Address - State:NJ
Mailing Address - Zip Code:08852-2600
Mailing Address - Country:US
Mailing Address - Phone:732-355-9146
Mailing Address - Fax:201-998-8772
Practice Address - Street 1:248 KEARNY AVE
Practice Address - Street 2:
Practice Address - City:KEARNY
Practice Address - State:NJ
Practice Address - Zip Code:07032-2505
Practice Address - Country:US
Practice Address - Phone:201-998-8787
Practice Address - Fax:201-998-8772
Is Sole Proprietor?:No
Enumeration Date:2010-07-20
Last Update Date:2010-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI03284800183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist