Provider Demographics
NPI:1366579807
Name:ZOOK, KELLY (MD)
Entity type:Individual
Prefix:DR
First Name:KELLY
Middle Name:
Last Name:ZOOK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:CHRISTIANA CARE HEALTH SYSTEM
Mailing Address - Street 2:DEPARTMENT OF NEONATOLOGY
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19718-0001
Mailing Address - Country:US
Mailing Address - Phone:302-733-2410
Mailing Address - Fax:
Practice Address - Street 1:CHRISTIANA CARE HEALTH SYSTEM
Practice Address - Street 2:DEPARTMENT OF NEONATOLOGY
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19718-0001
Practice Address - Country:US
Practice Address - Phone:302-733-2410
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-28
Last Update Date:2015-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEC7-00032612080N0001X
CT547592080N0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080N0001XAllopathic & Osteopathic PhysiciansPediatricsNeonatal-Perinatal Medicine