| Doctor Name: | DR. J. PATRICK KELLY |
| NPI Number: | 1184642597 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PHD |
| License Number: | |
| Business Practice Address: | 475 Market St First Floor Elmwood Park, NJ - 074073126 |
| Business Phone Number: | 2017911499 |
| Business Fax Number: | 2017913529 |
| Mailing Address: | 475 Market St, First Floor ELMWOOD PARK |
| State: | NJ |
| Postal Code: | 074073126 |
| Phone Number: | 2017911499 |
| Fax Number: | 2017913529 |
| NPI Enumeration Date: | 07/17/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP1600X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NJ |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Pastoral |
| Taxonomy Definition: | |