Paul Mitchell Kelleher

Primary specialty

Sports Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081S0010X

License

206597 Issued in NY

Legal business name

PAUL MITCHELL KELLEHER

Practice address

4434 Amboy Rd
Staten Island, NY 10312-3866

Phone

(718) 227-7015

NPI assigned

May 30, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Paul Mitchell Kelleher, D.O.NPI 1326052473

Title

Physician

Phone

(717) 818-3167

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Paul Mitchell Kelleher, D.O.

  • Physical Medicine & Rehabilitation Physician
  • Millington, NJ
  • NPI 1326052473
  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1180483200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1598966244",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "49 W RAYBURN RD",
            "city": "MILLINGTON",
            "state": "NJ",
            "postal_code": "079461502",
            "telephone_number": "908-542-1792"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4434 AMBOY RD",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103123866",
            "telephone_number": "718-227-7015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAUL MITCHELL KELLEHER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-30",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KELLEHER",
        "authorized_official_first_name": "PAUL",
        "authorized_official_middle_name": "MITCHELL",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "717-818-3167",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "2081S0010X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Medicine & Rehabilitation, Sports Medicine",
            "state": "NY",
            "license": "206597",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Candice Gabriella Patti, OTR/L
• Tara Patti
• Muruga Reddy Pattiputtur, PT
• Janice A Pattison, NP-C
• Albert Brian Patton, MD
• Dzeneta Paul-Bazil
• Elsie Paul
• Elzbieta Paul
• Joseph Paul, PHARM.D
• Katushia Paul

• Sports Medicine (Physical Medicine & Rehabilitation) Physician in Staten Island, NY
• Providers in Staten Island, NY by specialty
• Sports Medicine (Physical Medicine & Rehabilitation) Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.