National Provider Identifier
Edward Robert Kelly
Edward Robert Kelly is listed in the NPPES registry with a primary specialty of Athletic Trainer in Ithaca, NY and a listed phone number of (607) 255-4237.
Profile Overview
- NPI
- 1891344024
- Provider Type
- Individual
- Primary Specialty
- Athletic Trainer
- Enumeration Date
- September 10, 2019
- Last Updated
- September 10, 2019
Practice Location
- 512 N Campus
- Ithaca, NY 14853-6007
Phone: (607) 255-4237
Mailing Address
- 214 E Upland RD
- Ithaca, NY 14850-2255
Specialties
- Athletic Trainer (2255A2300X)
Full Record
- NPI
- 1891344024
- Entity Type
- Individual
- Last Name
- Kelly
- First Name
- Edward
- Middle Name
- Robert
- Mailing Street Address
- 214 E Upland RD
- Mailing City
- Ithaca
- Mailing State
- NY
- Mailing ZIP Code
- 14850-2255
- Mailing Country
- US
- Mailing Phone
- (607) 255-4237
- Practice Street Address
- 512 N Campus
- Practice City
- Ithaca
- Practice State
- NY
- Practice ZIP Code
- 14853-6007
- Practice Country
- US
- Practice Phone
- (607) 255-4237
- Enumeration Date
- September 10, 2019
- Last Updated
- September 10, 2019
- Sex
- Male
- Sole Proprietor
- Yes
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Athletic Trainer (2255A2300X)
- Other Identifiers
- 00039 (NY, New York Sate)