Provider Demographics
NPI:1285954388
Name:QUERCETTI, KELLI ANN (DO)
Entity type:Individual
Prefix:DR
First Name:KELLI
Middle Name:ANN
Last Name:QUERCETTI
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18947 JOHN J WILLIAMS HWY
Mailing Address - Street 2:SUITE 201
Mailing Address - City:REHOBOTH BEACH
Mailing Address - State:DE
Mailing Address - Zip Code:19971-4474
Mailing Address - Country:US
Mailing Address - Phone:302-645-4801
Mailing Address - Fax:
Practice Address - Street 1:2112 PROVIDENCE AVE
Practice Address - Street 2:
Practice Address - City:CHESTER
Practice Address - State:PA
Practice Address - Zip Code:19013-5507
Practice Address - Country:US
Practice Address - Phone:610-874-5366
Practice Address - Fax:610-874-8448
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-11
Last Update Date:2021-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEC2-0011373207YX0905X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207YX0905XAllopathic & Osteopathic PhysiciansOtolaryngologyOtolaryngology/Facial Plastic Surgery