Bethea, Kelly Melinda

Bethea, Kelly Melinda is an individual health care provider with primary practice located at 5501 Old York Rd Paley 1St Floor, Philadelphia PA 19141-3018. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Adolescent Medicine, Allopathic & Osteopathic Physicians / Pediatrics. Allopathic & Osteopathic Physicians / Pediatrics is her primary health care specialty. Bethea, Kelly Melinda can be contacted via phone (215) 456-7170.

Contact Information

Primary practice address
5501 Old York Rd Paley 1St Floor Philadelphia PA 19141-3018
Phone: (215) 456-7170
Fax: (215) 456-4923
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Adolescent Medicine 2080A0000X 226589 New York
Allopathic & Osteopathic Physicians / Pediatrics 208000000X MD070520L Pennsylvania

Profile Details

NPI number 1992705115
LBN Legal business name Bethea, Kelly Melinda
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 29th, 2005
Last updated Aug 28th, 2014 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1992705115 NPPES
New York MEDICAID 02354483
New York MEDICAID 102377102

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