Kelly Sykes, PA-C

Individual provider Active NPI Medical Physician Assistant · Brigantine, NJ

NPI 1629327655 · NPPES record last updated Sep 5, 2012

Key facts

NPI
1629327655
Entity type
Individual (NPI type 1)
Primary specialty
Medical Physician Assistant 363AM0700X
License
25MP00288400 (NJ)
Practice address
4248 Harbour Beach Blvd
Brigantine, NJ 08203-1361
Phone
(609) 266-0400
NPI assigned
Sep 5, 2012
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 25MP00288400 NJ Yes

Addresses

Primary practice location

4248 Harbour Beach Blvd
Brigantine, NJ 08203-1361

Mailing address

4248 Harbour Beach Blvd
Brigantine, NJ 08203-1361

Other providers in Brigantine, NJ

All providers in Brigantine, NJ · Medical Physician Assistant in New Jersey

Sources for this page

Verify at the official NPI Registry.