SANDRA KELLUM (NPI# 1669881397) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1669881397 |
| Entity Type | Individual |
| Full Name | SANDRA KELLUM |
| Credential | M.D. |
| Practice Address |
24 Yantecaw Ave Bloomfield NJ 07003-2835 |
| Practice Telephone | 2012758742 |
| Mailing Telephone | 2012758742 |
| Enumeration Date | 2014-08-06 |
| Last Update Date | 2018-04-20 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208000000X | Pediatrics | 25MA10083400 | NJ | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NJ | ST. JOSEPH'S HEALTHCARE SYSTEM | 39 | 01 |
| Street Address |
24 YANTECAW AVE |
| City | BLOOMFIELD |
| State | NJ |
| Zip Code | 07003-2835 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316560501 | Delores Heart,llc | Respite Care | Delores Heart, 17 Dodd St. Ste A5, Bloomfield, NJ 07003 | 2020-05-21 |
| 1235798505 | Tina Rivera | Physical Therapy Assistant | A Team Approach, Pt 265 Broad Street, Suite 4, Bloomfield, NJ 07003 | 2019-06-11 |
| 1144709239 | Jennifer Stuart | Social Worker | 27 Park Place, Apt. 13, Bloomfield, NJ 07003 | 2018-08-09 |
| 1992212179 | Kristina Camille P Manapat | Student in an Organized Health Care Education/Training Program | 1690 Broad St., Bloomfield, NJ 07003 | 2018-01-09 |
| 1760993224 | Vivian Arroyo | Counselor | 76 Baldwin Pl, Bloomfield, NJ 07003 | 2017-10-23 |
| 1942719653 | Savita Singh | Dentist | 40 Conger Street, 1402b, Bloomfield, NJ 07003 | 2017-09-26 |
| 1942729926 | Moya Mathison | Counselor | 27 West St # 5a, Bloomfield, NJ 07003 | 2017-09-11 |
| 1801319512 | Janice Rainford | Counselor | 267 Broughton Ave # 2, Bloomfield, NJ 07003 | 2017-07-25 |
| 1154841468 | Nhat Minh Nguyen | Nurse Practitioner | 3 Donald St, Apt. D, Bloomfield, NJ 07003 | 2017-06-27 |
| 1578091872 | Janice M. Steel | Physical Therapy Assistant | 265 Broad Street, Suite 4, Bloomfield, NJ 07003 | 2017-05-31 |
| Find all providers in zip 07003 | ||||
| Taxonomy Code | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154576049 | Sean A Flynn | Pediatrics | 299 Glenwood Ave, 2nd Floor, Suite 6, Bloomfield, NJ 07003-2445 | 2008-11-19 |
| 1114177540 | Ruchi Mehta | Pediatrics | 106 Broad Street, Bloomfield, NJ 07003 | 2008-09-22 |
| 1316113376 | Sarah Elizabeth Flemming | Pediatrics | 55 N Judge St, Bloomfield, IN 47424 | 2008-04-30 |
| 1598863649 | Guo-pao Cheng | Pediatrics | 160 Bloomfield Ave, Bloomfield, NJ 07003-5620 | 2006-09-20 |
| 1316059033 | Madhavi Shah | Pediatrics | 199 Broad Street, Suite 1b, Bloomfield, NJ 07003 | 2006-08-31 |
| 1629091798 | Lawrence Rifkin | Pediatrics | 57 Jolley Dr Ste B, Bloomfield, CT 06002-3062 | 2006-07-26 |
| 1376582734 | Lori Ann Colyer-aversa | Pediatrics | 399 Hoover Ave, Suite 5, Bloomfield, NJ 07003-3924 | 2006-06-04 |
| 1396716767 | Edna Retiracion Lopez-maslak | Pediatrics | 206 Belleville Ave Ste 202, Bloomfield, NJ 07003-3589 | 2006-02-01 |
| 1235522194 | Primary Care Partners, LLC | Pediatrics | 399 Hoover Ave, Suite 5, Bloomfield, NJ 07003-3924 | 2015-03-16 |
| 1356730915 | Primary Care Partners, LLC | Pediatrics | 329 Belleville Ave, 2nd Floor, Bloomfield, NJ 07003-3600 | 2015-01-20 |
| Find all providers in BLOOMFIELD | ||||
| City | BLOOMFIELD |
| Zip Code | 07003 |
Please comment or provide details below to improve the information on SANDRA KELLUM.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.