IndividualActive
Michael Kelly, D.O.
NPI 1265583884 · Sports Medicine (Internal Medicine) Physician · West Orange, NJ
Provider details
- NPI number
- 1265583884
- Entity type
- Individual
- Primary specialty
- Sports Medicine (Internal Medicine) PhysicianAllopathic & Osteopathic Physicians
- Credential
- D.O.
- Sex
- Male
- Sole proprietor
- Yes
- License
- 25MB07620900 (NJ)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Practice location
622 Eagle Rock Ave
Suite 305
West Orange, NJ 07052
Phone: (973) 736-1939
Fax: (973) 736-1937
Approximate (ZIP-level) locationGet directions
Mailing address
622 Eagle Rock Ave
West Orange, NJ 07052
Registry dates
- Enumerated
- 2007-01-12
- Last updated
- 2026-03-16
- Certified
- 2026-03-16
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.