1598217820 NPI number — KELSCH ASSOCIATES INC. NEW JERSEY

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1598217820 NPI number — KELSCH ASSOCIATES INC. NEW JERSEY

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
KELSCH ASSOCIATES INC. NEW JERSEY
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1598217820
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/04/2017
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
368 BROADWAY
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WESTVILLE
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
08093-1193
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
856-456-2022
Provider Business Mailing Address Fax Number:
856-456-4372

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4 BLATHERWICK DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BERLIN
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
08009-2204
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
856-767-3967
Provider Business Practice Location Address Fax Number:
856-767-5638
Provider Enumeration Date:
11/03/2016

Additional Information

Authorized Official

Authorized Official Last Name:
AMORIELLO
Authorized Official First Name:
PATTI
Authorized Official Middle Name:
Authorized Official Title or Position:
EXECUTIVE DIRECTOR
Authorized Official Telephone Number:
856-456-2022

Provider Taxonomy Codes

  • Taxonomy code: 320900000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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