Provider Demographics
NPI:1487601852
Name:KELLY, ELIZABETH LEPINNET (PT, DPT)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:LEPINNET
Last Name:KELLY
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:51 ELM STREET
Mailing Address - Street 2:
Mailing Address - City:DELHI
Mailing Address - State:NY
Mailing Address - Zip Code:13753
Mailing Address - Country:US
Mailing Address - Phone:607-746-7835
Mailing Address - Fax:
Practice Address - Street 1:51 ELM ST
Practice Address - Street 2:
Practice Address - City:DELHI
Practice Address - State:NY
Practice Address - Zip Code:13753-1208
Practice Address - Country:US
Practice Address - Phone:607-746-7835
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-30
Last Update Date:2013-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY027320225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYRA8046Medicare PIN
NYQ24E31Medicare PIN