Kelling, Timothy S
Kelling, Timothy S is an individual health care provider with primary practice located at 4 Fairfield Dr , Queensbury NY 12804-1514. He recently has 2 registered licenses in different health care specialties including Dental Providers / Dentist, Other Service Providers / Specialist. Other Service Providers / Specialist is his primary health care specialty. Kelling, Timothy S can be contacted via phone (518) 793-9424.Contact Information
Primary practice address
4 Fairfield Dr
Queensbury NY 12804-1514
Phone: (518) 793-9424
Fax: (518) 793-9441
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Dentist | 122300000X | 0487231 | New York |
| Other Service Providers / Specialist | 174400000X | 2278311 | New York |
Profile Details
| NPI number | 1821012881 |
|---|---|
| LBN Legal business name | Kelling, Timothy S |
| Credentials | D.D.S, M.D |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 26th, 2006 |
| Last updated | Mar 28th, 2016 - about 10 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1821012881 | NPPES |
| New York | MEDICAID | 02348676 | |
| New York | MEDICAID | 02567155 |
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