Provider Demographics
NPI:1841685948
Name:KELLY, CHRISTINE ELIZABETH ANNE (MD)
Entity type:Individual
Prefix:DR
First Name:CHRISTINE
Middle Name:ELIZABETH ANNE
Last Name:KELLY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:CHRISTINE
Other - Middle Name:ELIZABETH ANNE
Other - Last Name:AZIZKHAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:4735 OGLETOWN STANTON RD STE 1116
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19713-2089
Mailing Address - Country:US
Mailing Address - Phone:302-368-8612
Mailing Address - Fax:302-623-6607
Practice Address - Street 1:4735 OGLETOWN STANTON RD STE 1116
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19713-2089
Practice Address - Country:US
Practice Address - Phone:302-368-8612
Practice Address - Fax:302-623-6607
Is Sole Proprietor?:No
Enumeration Date:2015-04-06
Last Update Date:2025-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.133697208000000X
DEC1-0013136208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics